Distribution of pulmonary blood flow after cavopulmonary anastomosis (Glenn operation).

Abstract

Anastomosis of the superior vena cava and right pulmonary artery (Glenn and Patiino, 1954; Edwards and Bargeron, 1968) is indicated in some patients with congenital heart disease associated with dimin- ished pulmonary blood flow. The procedure repre- sents a major interference with pulmonary haemo- dynamics. The blood supply to the right lung then comes from the superior vena cava and from the bronchial collaterals. The blood to the left lung comes from the inferior vena cava and from the systemic vascular bed via anastomoses. A part of the venous return from the inferior vena cava passes through interatrial or interventricular com- munications directly into the systemic circulation without having passed through the lungs. The total pulmonary blood flow after cavopulmonary anastomosis increases. The ratio between the left and right pulmonary blood flow varies according to the magnitude of the intracardiac shunt.