Longitudinal Survival Of Glenn Patients Over Thirty Years (1958-1990) Beginning With Dr. William Glenn's First Patient
Madonna E. Lee, MD, Andrea Amabile, MD, Arnar Geirsson, MD, Peter J. Gruber, MD, PhD, Gary S. Kopf, MD.
Yale University School of Medicine, New Haven, CT, USA.
Objectives: Historically, Dr. William Glenn performed the first classic superior cavo-pulmonary anastomosis in a 7-year-old child in 1958. By 1990, this procedure was performed consecutively in over 90 patients. With over sixty years of follow-up, this is the longest survival record of early Glenn patients from the first 30 years.
Methods: We performed a single-center retrospective evaluation of patients undergoing a Glenn operation. A collected list of surviving patients, previously updated in 1988, included demographics, age at procedure, and underlying diagnosis. Follow-up data was updated in May 2022 using electronic medical records to determine survival, age of survivors, and age of deceased.
Results: Ninety-five patients underwent Glenn operation from 1958-1990: 58.9% (n=56) were male and 41.1% (n=39) female. Fifteen patients were lost to follow-up, but 12 were alive in 1988. Sixty patients were deceased (63.8%): average age 32.3 (range 1.3-78 years, excluding 6 early deaths). The oldest patient who passed away was a 78-year-old male with Tetralogy of Fallot. Twenty patients remain alive, with an average age of 47.5 (range 32-66 years). Four patients who are still alive today (20% of survivors) are older than 60 years old.
Conclusions: Since Dr. Glenn's original operation, the technique, timing, and indications have been modified (i.e., bidirectional Glenn) to adapt to the current era. By following this initial group of patients, we can start to understand the survival rates for adult congenital patients who were some of the first pediatric patients to receive this ground-breaking staged palliative procedure.
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