When the doctor told you that your little one needs to have a 'Glenn' procedure because of a heart problem, you must have felt a lot of fear and shock. You must have many questions in your mind, such as what is a 'Glenn Procedure', what does it involve, and why is it being done. Don't worry. Those feelings are very normal. Let's talk about all of this simply, in a way that you can understand.
What is the Glenn Procedure in simple terms?
Think about it, our heart is the motor that pumps blood throughout the body. It has four parts (four chambers). Some babies are born with one of these chambers not fully developed or is very small. In this case, the heart is unable to pump blood properly.
Simply put, the Glenn procedure is a 'bypass' procedure that helps a weak heart like this.
Here, surgeons connect the main blood vessel (superior vena cava), which carries oxygen-poor, impure blood from the baby's upper body, directly to the pulmonary artery, instead of sending it to the heart.
This is like building a new, easier-to-use road that bypasses a busy road. This allows the blood that needs to get oxygen to bypass the problematic part of the heart and go straight to the lungs.
This is usually the second surgery a baby has. Another surgery is performed a few years later to provide a permanent solution to the condition.
What kind of children are this surgery performed on?
Glenn's surgery is mainly performed on children with congenital heart defects. It is especially necessary for very young children, or for those in whom one of the two main chambers (ventricles) of the heart that pumps blood does not work properly. This condition is called a 'single ventricle defect'.
Below are some of the main heart conditions that require Glenn surgery.
| Name of the heart disease (Medical Condition) | A simple explanation |
|---|---|
| Hypoplastic Left Heart Syndrome | The left side of the heart (left ventricle, valves) does not develop properly. |
| Tricuspid Atresia | The tricuspid valve, located between the chambers on the right side of the heart, is not formed properly. |
| Pulmonary Atresia | The pulmonary valve that carries blood to the lungs is blocked. |
| Double Inlet Left or Right Ventricle | The two upper chambers of the heart (atria) connect to a single lower chamber (ventricle). |
When is Glenn surgery usually performed?
Doctors usually recommend this surgery when the baby is between 3 and 6 months old . It is often performed as a second surgery, after the baby has had an initial surgery to improve blood circulation (such as a Blalock-Taussig (BT) shunt) after birth.
What happens before and during surgery?
Before surgery
Before the surgery, your doctor will perform several tests to better assess the condition of your baby's heart.
- Cardiac Catheterization: This test is done to measure the pressure and oxygen levels inside the heart and to look at the structure of the heart.
- Heart MRI: This helps to obtain detailed three-dimensional images of the heart.
- It is very important to inform the doctor about all medications (including vitamins and supplements) that your baby is taking .
During surgery
A c-section usually takes about four hours , but this time can vary depending on the baby's condition.
During the surgery, the baby is given anesthesia, so the baby does not feel any pain. The baby is in a deep sleep. Some children are connected to a special machine that temporarily takes over the work of the heart and lungs during the surgery. This is called a cardiopulmonary bypass machine . Then, as mentioned earlier, the surgeon performs the blood vessel reconnection and other heart repairs if necessary.
Benefits and possible risks of surgery
Like any surgery, the Glenn procedure has both benefits and risks. It's important for parents to be aware of these.
| Advantages | Possible risks/complications |
|---|---|
| Decreased weight of the only working heart chamber (ventricle). | Decreased oxygen levels in the blood. |
| Preventing the heart from becoming enlarged due to overwork. | High blood pressure. |
| The upcoming Fontan surgery will be easier. | Pleural effusions. |
| Increased chances of saving the child's life after Fontan surgery. | Having to be fed through a tube due to difficulty eating. |
| Being an alternative for children who do not need or cannot have the Fontan operation. | Having to have another surgery. |
The most important thing is that the survival rate of the child after the Glenn operation is very high. It is approximately 99% . This is a very successful operation.
What happens after the surgery?
After the surgery, the baby will be admitted to the intensive care unit (ICU). You may feel scared when you see the tubes and monitors attached to the baby's body. But that's normal. The medical team will monitor the baby very closely.
The baby will stay in the intensive care unit for about three days, then be transferred to a regular ward. It may take several weeks for the baby to fully recover and go home.
Many children, a few years after the Glenn procedure, when they start walking, will need to undergo the next step, a Fontan procedure , which provides a more permanent solution to the heart's circulatory system.
When do you need to see the doctor after you go home?
It is very important to take good care of your baby after you go home. If you notice any of the following symptoms , call your doctor immediately.
- If the baby has a fever.
- If blood or other fluid is leaking from the surgical wound.
- If you have difficulty drinking milk.
- If you have a problem with weight gain.
Your child will have to go to a cardiologist's clinic and take medication for a long time. That's part of this journey.
Take-Home Message
- The Glenn Procedure is a planned, second-stage surgery performed on babies with complex congenital heart disease.
- This means that oxygen-poor blood is sent directly to the lungs, bypassing the heart, reducing the workload on the heart.
- The success rate of this surgery is very high (about 99%). So don't be afraid.
- After surgery, the child will need long-term medical supervision and medication, so it is very important to follow the doctor's instructions.
- Talk openly with your doctor about any questions or fears you have. They are there to help you.
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