Pediatric Heart Expert Forum
Age for Glenn Procedure
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Age for Glenn Procedure

My daughter is 3 weeks old and has been diagnosed with DORV w/ TGA, VSD and narrowing of the PA.  She is currently being treated with diuretics and is stable but her weight gain is inconsistent so it remains to be seen if she will remain stable or will need the PA banding.  In speaking with our Pediatric Cardiologist, he stated that the path forward was to complete the Glenn Procedure at approx. 7 weeks of age.    I was surprised when he stated this as from everything I have read it is typically done around 6 months. Is it a common approach to complete the Glenn Procedure at 7 weeks?  The benefit, according to our doctor, would be the elimination of the need for a separate banding procedure.

Thanks.

JJO
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Dear JJO,

The Glenn is frequently performed typically between 2 and 6 months of age, or so.  It is more a function of a few things, including ensuring that the pulmonary vascular resistance has fallen (the amount of resistance to blood flow across the lungs, which starts out elevated in all babies), the size of the pulmonary arteries, heart function, and the baby's oxygen saturations.  Without evaluating your daughter, I cannot say for sure what the optimal timing will need to be for the Glenn.  Certainly, avoidance of a pulmonary artery band would be nice, as they tend to distort the pulmonary arteries which can lead to obstruction later on.  However, not placing it leads to the risk of congestive heart failure if there is too much overcirculation into the lungs.  This can lead to poor growth and make your daughter a worse surgical risk.  Therefore, your cardiologist will have to watch her closely to ensure that she is well balanced from that standpoint.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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