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A procedure called the Glenn (or bidirectional Glenn) is used to improve blood circulation in a heart with a tiny left or right side (either the chamber that pumps blood or the valve that connects the upper and lower chambers). When your child's pulmonary arteries are attached to their superior vena cava, oxygen-demanding blood can flow directly to their lungs.

Your superior vena cava returns your upper body's oxygen-depleted blood. Under normal circumstances, this blood would be given oxygen by flowing through your heart's chambers and into your pulmonary artery. With the Glenn procedure, oxygen-depleted blood can be delivered to your lungs directly by bypassing a problematic heart area.

Infants can have one or more operations shortly after they're born, most commonly followed by this one. Infants may need a further operation a few years later for a longer-term solution.

Children with complex congenital heart defects involving a single functional ventricle, such as tricuspid atresia or hypoplastic left heart syndrome, may undergo the Glenn procedure, a type of palliative heart surgery. These abnormalities hinder the heart's ability to pump blood to the lungs effectively. The Glenn treatment bypasses the heart and reroutes blood flow from the upper body to the lungs, improving oxygenation.

Parents should seek pediatric cardiology care if their child has a known congenital heart defect or shows symptoms such as cyanosis (bluish skin or lips), poor feeding, fatigue, or failure to thrive. Children with single ventricle physiology are usually diagnosed at or before birth and are closely monitored through staged surgical care. Timely evaluation and surgical planning by a pediatric cardiac team are crucial for optimal outcomes.

Preoperative preparation includes a complete cardiac evaluation, including echocardiography, cardiac catheterisation, MRI, and blood testing to determine heart anatomy and lung pressures. The child’s overall health must be stabilised before surgery, which may require controlling oxygen levels, medications, and diet. The care team will advise parents on how to get their child ready, including how to stop taking certain medications and fast.

Procedure: The surgeon attaches the right pulmonary artery to the superior vena cava (SVC), the sizable vein that transports blood from the upper body. This eliminates the need for the heart to pump deoxygenated blood to the lungs.
Circulation Management: A heart-lung machine (cardiopulmonary bypass) may be temporarily needed for the procedure.
Closure and Monitoring: Following the connection, the child is moved to the pediatric intensive care unit (PICU) for close observation and recuperation. The chest is then closed.

The Glenn treatment typically takes four to six hours, and depending on complications and healing progress, the length of the postoperative hospital stay can vary from one to three weeks.

Bleeding or infection
Arrhythmias
Pleural effusion or fluid buildup
Low oxygen levels (desaturation)
Thrombosis or clotting in the new connection
Prolonged ventilator support

The Glenn procedure improves oxygen delivery and reduces the workload on the single-functioning ventricle. It increases survival and growth and stabilises youngsters with single-ventricle defects.

Respiratory care, medications to control blood flow and rhythm, and progressive refeeding are all part of recovery. Echocardiograms and oxygen monitoring are part of the follow-up. Following recovery, most kids report feeling more energised and having higher oxygen saturation levels.

Over 90% of kids recover well and move on to the following surgical stage after the Glenn procedure, which has a high success rate in skilled pediatric cardiac clinics.