Bidirectional Glenn Shunt Allows for Closure of a Cyanotic Atrial Septal Defect in an Adult.

Aaron J Rhee, Michael Argilla, Ralph Mosca, Adam J Small, Dan G Halpern

Abstract readCase Reports

In one paragraph

Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Aaron J RheeDepartment of Medicine, New York University, New York, New York, USA. Electronic address: Aaron.Rhee@nyulangone.org.

Michael ArgillaDivision of Pediatric Cardiology, New York University, New York, New York, USA.

Ralph MoscaDivision of Pediatric and Adult Congenital Cardiothoracic Surgery, New York University, New York, New York, USA.

Adam J SmallDivision of Cardiovascular Medicine, New York University, New York, New York, USA.

Dan G HalpernDivision of Cardiovascular Medicine, New York University, New York, New York, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are multiple potential etiologies for right-to-left shunting across a large atrial septal defect (ASD). CASE SUMMARY: A 34-year-old woman who presented with exertional dyspnea was found to be cyanotic due to right-to-left shunting across a secundum ASD and hypoplastic right ventricle (RV) due to an abnormal interventricular septum. Balloon occlusion of the ASD resulted in a significant drop in systemic cardiac output, so the patient underwent bidirectional Glenn shunt to both unload and partially bypass a hypoplastic RV, allowing for ASD closure. DISCUSSION: The bidirectional Glenn shunt is primarily used in the staged palliation of single-ventricle physiology in pediatric patients, and its use in adults is rare. In this case, its use allowed for hemodynamic tolerance of ASD closure with a hypoplastic RV. TAKE-HOME MESSAGE: This case exemplifies the complex hemodynamics that goes into consideration of ASD closure with an abnormal RV.

Indexed as

atrial septal defectcardiac magnetic resonancecongenital heart defectcyanotic heart diseasehemodynamicspulmonary hypertensionright ventricle

Identifiers

PMID40681268

DOI10.1016/j.jaccas.2025.104046

PMCPMC12441458

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LicenceCC BY-NC-ND

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.