ArticleJTCVS open2026
Surgical strategies to avoid Glenn physiology during staged left heart recruitment.
Article in JTCVS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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9 authors.
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Abstract
Objectives: Staged left ventricular recruitment can promote left ventricular growth through controlled volume loading. The optimal pulmonary blood flow source and the need for the bidirectional Glenn during staged left ventricular recruitment remain unclear. This study investigates staged left ventricular recruitment outcomes in patients who underwent staged left ventricular recruitment with or without the bidirectional Glenn. Methods: This is a single-institution retrospective review of children undergoing staged left ventricular recruitment (2014-2024). Patients were stratified by pulmonary blood flow source: nonbidirectional Glenn (shunt/Sano upsize or pulmonary artery band alone) and bidirectional Glenn. Results: Eighty-eight patients underwent staged left ventricular recruitment with shunt upsizing (n = 11), pulmonary artery band (n = 9), or bidirectional Glenn/super-Glenn (n = 68). Median age at recruitment was 231 days (interquartile range, 495.25). Fundamental diagnosis was hypoplastic left heart syndrome/complex in 44 patients (50%). Median duration of recruitment was 642 days (576.5); duration was significantly lower in the nonbidirectional Glenn group compared with the bidirectional Glenn group (321 [480] days vs 754 [481] days) ( Conclusions: Shunt upsizing and pulmonary artery band modification can be effective for ventricular volume loading during staged left ventricular recruitment, enabling biventricular conversion while avoiding potential complications of bidirectional Glenn physiology. These strategies should be considered in patients not anticipated to require prolonged recruitment and in patients deemed poor bidirectional Glenn candidates.
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