To evaluate the clinical usefulness of pulsatile bidirectional Glenn shunt.Between June 1994 and January 2000, pulsatile bidirectional Glenn shunt was operated on 41 patients, 31 males and 10 females, aged 5 +/- 4 Y (7M approximately 16Y) and with the body surface area of 0.64 +/- 0.25 m(2) (0.35 approximately 1.48 m(2)), 35 operations being performed under hypothermia with cardiopulmonary bypass, and the other 6 operations being performed at ordinary temperature without cardiopulmonary bypass. The SaO(2) before operation was 70% +/- 11% (25% approximately 89%). The pulmonary pressure measured during operation was 12.5 mm Hg +/- 2.7 mm Hg (8 approximately 17 mm Hg).One patient died in the early postoperative period, three got chylothorax, and the others made uneventful recovery. This operation provides excellent early palliation of cyanosis. The average SaO(2) was 90% +/- 4% (77% approximately 96%) on discharge. The time of postoperative respirator usage duration was shorter in those patients who underwent operation at ordinary temperature without cardiopulmonary bypass.The pulsatile bidirectional Glenn shunt, easy to perform and with good early postoperative effects, is a useful procedure in the early management of patients with a functional univentricular heart.