POST GLENN

1. CATH MEET
21/09/2019
Murtaza Kamal
1

2. Patient’s details
• B/O R 11M/ M: T/AGA/ 2.75 kg/ CIAB Cyanosis on D1 of life (Spo2-
70%)
• Evaluation done: Situs ambiguous, dextrocardia, dextroposition, C-
AVSD with unbalanced ventricles with pulmonary stenosis
• Planned single ventricle repair, propranolol started
• 6months of age: Lt BDG
• Underwent right pleural-peritoneal shunt with thoracic duct ligation
for refractory pleural effusion: 7 months
• Swelling in upper part of body+ extremities with dilated superficial
veins on upper part of body
2

3. Examination
• Conscious, alert, playful, no cranio- fascial dysmorphism
• PR: 102/ min, RR: 22/min, BP: 98/62 mm hg, Afebrile, spo2- 68%
• Wt: 6kg, length: 70 cm
• Cyanosis +, dilated veins on upper part of chest with flow from up to
down
• Apex- 4th ICS on right side, midline scar, silent chest, S1: Normal, S2:
Single, No S3, S4, No murmur or additional sounds
• Liver dullness on lt side,
3

4. CXR
4

5. ECG
5

6. ECHO
• Situs ambiguous, dextro position, dextrocardia
• S/P Lt BDG for C-AVSD with unbalanced ventricles with PS
• Patent glenn shunt, Good flow in BPAs
• No forward flow across PA
• No AVVR
• Good ventricular function
• No PE, clot, vegetation
6

7. Cardiac cath
• Indication: Assessment of Glenn + PA pressures and anatomy
• Access: 5F RFV, 4F RIJV
• 100U/kg heparin iv, seldinger technique for access
• Hardware: 5F MPA endhole, 4F JR, regular and terumo wires
• Vitals: HR: 110/ min, RR: 24/ min, BP: 102/74mm hg, Temp: 98 d,
spo2: 62%
• Hb: 9.8 g/dl
7

8. GLENN
8

9. LV AND GLENN
9

10. LV-EDP
10

11. Angios
• RPA: -2.01
• LPA: -1.99
11

12. Thank you
12