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Bidirectional cavopulmonary anastomosis (BDCPA) or the Glenn shunt was introduced by Azzolina et al. and is a commonly performed palliative procedure contemplated in complex cyanotic congenital heart disease of varying etiology.[1] BDCPA is characterized by an anastomosis between the superior vena cava (SVC) and the right pulmonary artery, thereby augmenting the pulmonary blood flow (PBF) without increasing the ventricular volume overload. The ongoing technical advancements and improved surgical expertise have resulted in a substantial number of BDCPA being performed on an off‐pump basis.

On-table extubation following off-pump bidirectional cavopulmonary anastomosis: Two sides of the coin