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Eur J Cardiothorac Surg 2006;29:1056-1058
© 2006 Elsevier Science NL

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Modified Damus–Kaye–Stansel procedure using aortic flap technique for systemic ventricular outflow tract obstruction in functionally univentricular heart

^a Department of Cardiovascular Surgery, Kyushu University Hospital, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
^b Department of Pediatrics, Kyushu University Hospital, Japan

Received 5 January 2006; received in revised form 8 March 2006; accepted 10 March 2006.

^_* Corresponding author. Tel.: +81 92 642 5557; fax: +81 92 642 5566. (Email: masudam{at}heart.med.kyushu-u.ac.jp).

Damus–Kaye–Stansel procedure is a useful method to relieve the systemic ventricular outflow tract obstruction in functionally univentricular heart. Regurgitation of pulmonary valve and recurrence of systemic ventricular outflow obstruction are the major concerns at the late phase of this procedure. Modification of original Damus–Kaye–Stansel procedure that can prevent the use of prosthetic materials is evaluated. The modified Damus–Kaye–Stansel procedure using aortic flap technique was performed in eight patients with functionally univentricular heart. Patients’ ages ranged from 3 to 28 months (mean 14 months). Follow-up period was 37 months as a mean (9–71 months), and the follow-up was complete. There was no operative mortality and no late death. In addition, there was no recurrence of systemic ventricular outflow tract obstruction throughout the follow-up period. Regurgitation of the pulmonary valve estimated by echocardiography at the latest follow-up was none to trivial in seven patients and mild in one. The modified Damus–Kaye–Stansel procedure using aortic flap technique is a safe, useful and reproducible technique to solve systemic ventricular outflow tract obstruction in functionally univentricular heart, and it can be an alternative for original technique or the so-called double-barrel modification.

Key Words: Damus–Kaye–Stansel procedure • Systemic ventricular outflow tract obstruction • Univentricular heart