• Heidi M Meyer, Danai Marange-Chikuni, MMed Anaesthesia, Liesl Zühlke, Beyra Roussow, Paul Human, and Andre Brooks.
• Division of Paediatric Anaesthesia, Department of Anaesthesia & Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Electronic address: heids_meyer@hotmail.com.
• J. Cardiothorac. Vasc. Anesth. 2022 Jun 1; 36 (6): 157315811573-1581.

ObjectivesLarge data sets have been published on short- and long-term outcomes following bidirectional Glenn surgery (BDG), or partial cavopulmonary connection, in high-income countries. Data from low-income and middle-income countries are few and often limited to the immediate postoperative period. The primary outcome was any in-hospital postoperative complication, assessed according to predefined criteria, in children who underwent BDG surgery at Red Cross War Memorial Children's Hospital.DesignA retrospective cohort study.SettingA tertiary teaching hospital.ParticipantsThe study authors identified 61 children (<18 years of age) who underwent BDG over 8 years. The median age of patients undergoing BDG was 2.5 years (interquartile range, 1.4-5.5 years).InterventionsBDG surgery.Measurements And Main ResultsThirty-five patients (57.4%) had a postoperative complication, with some patients (17 of 61, 27.9%) having more than 1 complication. The most frequent complications were infective (29.5%). Univariate analysis found that postoperative complications were associated with the use of nitric oxide (p = 0.004) and a longer duration of anesthesia (p = 0.045) and surgery (p = 0.004). Patients with complications spent longer in the pediatric intensive care unit (ICU) (p < 0.001) and in the hospital (p < 0.012). On multivariate analysis, a priori risk factors based on previous studies were not found to be statistically significant. A total of 37.3% of patients completed their single-ventricle palliation, and 30.5% of patients were lost to follow-up.ConclusionsImportant findings were the older age at which the BDG was performed compared to high-income countries, an acceptable mortality rate of 3.3%, infection being the most common complication, the association of a complication with increased ICU and hospital lengths of stay, and the high rate of patients lost to follow-up.Copyright © 2022 Elsevier Inc. All rights reserved.

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