HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Doff B. McElhinney Norman H. Silverman Frank L. Hanley Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McElhinney, D. B. Articles by Hanley, F. L. Search for Related Content PubMed PubMed Citation Articles by McElhinney, D. B. Articles by Hanley, F. L.

J Thorac Cardiovasc Surg 1997;114:718-726
© 1997 Mosby, Inc.

SURGERY FOR CONGENITAL HEART DISEASE

MODIFIED DAMUS-KAYE-STANSEL PROCEDURE FOR SINGLE VENTRICLE, SUBAORTIC STENOSIS, AND ARCH OBSTRUCTION IN NEONATES AND INFANTS: MIDTERM RESULTS AND TECHNIQUES FOR AVOIDING CIRCULATORY ARREST

Received for publication May 7, 1997 revisions requested June 12, 1997; revisions received July 11, 1997 accepted for publication July 17, 1997. Address for reprints: V. Mohan Reddy, MD, 505 Parnassus Ave., M589, San Francisco, CA 94143-0118.

Abstract

Background: A modified Damus-Kaye-Stansel procedure is one of several options for palliation of single ventricle with subaortic obstruction, but results in neonates have been disappointing. In the presence of arch obstruction, this procedure is typically performed with circulatory arrest, which may contribute to neurologic insult. Methods: Since 1990, a modified Damus-Kaye-Stansel procedure has been performed in 14 neonates and seven infants with single ventricle and subaortic stenosis, including 15 with arch obstruction. Diagnoses were double-inlet left ventricle (n = 12), tricuspid atresia (n = 2), and other forms of hypoplastic ventricle with subaortic obstruction (n = 7). Three patients underwent concurrent bidirectional Glenn shunt. In the most recent seven patients with arch obstruction, arch repair was achieved with an end-to-side anastomosis of the descending aorta to the ascending aorta with continuous upper body perfusion. Results: One early death occurred among the 14 neonates (7%) and three among the infants, for an early mortality of 19%. At a median follow-up of 33 months, there were no late deaths or neurologic complications. Nine patients underwent subsequent bidirectional Glenn anastomosis, including three who had Fontan completion and one who later underwent conversion to a partial biventricular repair. One patient required a transplant for cardiomyopathy of unknown etiology. The remaining 12 patients are considered good candidates for Fontan completion. No patient has recurrent arch obstruction. Four patients have mild (n = 1) or trivial (n = 3) semilunar valvular regurgitation. Conclusion: The modified Damus-Kaye-Stansel procedure is an effective primary palliation for single ventricle and subaortic stenosis, with or without arch obstruction. Results are especially encouraging in neonates. Arch repair can be achieved without circulatory arrest to the brain .

This article has been cited by other articles:

				H. Zhang, P. Cheng, J. Hou, L. Li, H. Liu, R. Liu, B. Ji, and Y. Luo Regional cerebral perfusion for surgical correction of neonatal aortic arch obstruction Perfusion, May 1, 2009; 24(3): 185 - 189. [Abstract] [PDF]

				P. K. Mishra Management strategies for interrupted aortic arch with associated anomalies Eur. J. Cardiothorac. Surg., April 1, 2009; 35(4): 569 - 576. [Abstract] [Full Text] [PDF]

				W. J. Brawn Editorial comment: Early pulmonary artery debanding with Damus-Kaye-Stansel procedure provides good haemodynamics for the Fontan circulation Eur. J. Cardiothorac. Surg., January 1, 2009; 35(1): 147 - 148. [Full Text] [PDF]

				A. M. Gaca, J. J. Jaggers, L. T. Dudley, and G. S. Bisset III Repair of Congenital Heart Disease: A Primer-Part 1 Radiology, June 1, 2008; 247(3): 617 - 631. [Abstract] [Full Text] [PDF]

				A. F Corno and M. Pozzi Safe Innominate Artery Cannulation for Cardiopulmonary Bypass in Neonates Asian Cardiovasc Thorac Ann, December 1, 2007; 15(6): 528 - 530. [Abstract] [Full Text] [PDF]

				J. G. Kwak, W.-H. Kim, A. Y. Oh, T. G. Yoon, H.-S. Kim, J. H. Chae, and S. Y. Park Is unilateral brain regional perfusion neurologically safe during congenital aortic arch surgery? Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 751 - 755. [Abstract] [Full Text] [PDF]

				G. Gargiulo, G. Oppido, E. Angeli, and C. P. Napoleone Neonatal aortic arch surgery MMCTS, July 23, 2007; 2007(0723): 2345. [Abstract] [Full Text] [PDF]

				G. Amir, C. Ramamoorthy, R. K. Riemer, C. R. Davis, F. L. Hanley, and V. M. Reddy Visual light spectroscopy reflects flow-related changes in brain oxygenation during regional low-flow perfusion and deep hypothermic circulatory arrest J. Thorac. Cardiovasc. Surg., December 1, 2006; 132(6): 1307 - 1312. [Abstract] [Full Text] [PDF]

				R. L. Hannan, M. A. Ybarra, J. W. Ojito, F. A. Alonso, A. F. Rossi, and R. P. Burke Complex Neonatal Single Ventricle Palliation Using Antegrade Cerebral Perfusion. Ann. Thorac. Surg., October 1, 2006; 82(4): 1278 - 1285. [Abstract] [Full Text] [PDF]

				Y.-T. Lan, R.-K. Chang, and H. Laks Outcome of patients with double-inlet left ventricle or tricuspid atresia with transposed great arteries J. Am. Coll. Cardiol., January 7, 2004; 43(1): 113 - 119. [Abstract] [Full Text] [PDF]

				T Rakow and C Bull Same patient, different advice: a study into why doctors vary Arch. Dis. Child., June 1, 2003; 88(6): 497 - 502. [Abstract] [Full Text] [PDF]

				W. M. DeCampli, G. Schears, R. Myung, S. Schultz, J. Creed, A. Pastuszko, and D. F. Wilson Tissue oxygen tension during regional low-flow perfusion in neonates J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 472 - 480. [Abstract] [Full Text] [PDF]

				C. Lim, W.-H. Kim, S.-C. Kim, J.-W. Rhyu, M.-J. Baek, S.-S. Oh, C.-Y. Na, and C. W. Kim Aortic arch reconstruction using regional perfusion without circulatory arrest Eur. J. Cardiothorac. Surg., February 1, 2003; 23(2): 149 - 155. [Abstract] [Full Text] [PDF]

				S. M. Bradley, J. M. Simsic, A. M. Atz, and B. H. Dorman The infant with single ventricle and excessive pulmonary blood flow: results of a strategy of pulmonary artery division and shunt Ann. Thorac. Surg., September 1, 2002; 74(3): 805 - 810. [Abstract] [Full Text] [PDF]

				C. I. Tchervenkov, S. J. Korkola, D. Shum-Tim, C. Calaritis, E. Laliberte, T. U. Reyes, and J. Lavoie Neonatal aortic arch reconstruction avoiding circulatory arrest and direct arch vessel cannulation Ann. Thorac. Surg., November 1, 2001; 72(5): 1615 - 1620. [Abstract] [Full Text] [PDF]

				C.I. Tchervenkov, S.J. Korkola, and D. Shum-Tim Surgical technique to avoid circulatory arrest and direct arch vessel cannulation during neonatal aortic arch reconstruction Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 708 - 710. [Abstract] [Full Text] [PDF]

				R. H. Pass, D. E. Solowiejczyk, J. M. Quaegebeur, L. Liberman, K. Altmann, W. M. Gersony, and A. J. Hordof Bulboventricular foramen resection: hemodynamic and electrophysiologic results Ann. Thorac. Surg., April 1, 2001; 71(4): 1251 - 1254. [Abstract] [Full Text] [PDF]

				F. A. Pigula, E. M. Nemoto, B. P. Griffith, and R. D. Siewers REGIONAL LOW-FLOW PERFUSION PROVIDES CEREBRAL CIRCULATORY SUPPORT DURING NEONATAL AORTIC ARCH RECONSTRUCTION J. Thorac. Cardiovasc. Surg., February 1, 2000; 119(2): 331 - 339. [Abstract] [Full Text] [PDF]

				J. N.K. Odim, H. Laks, D. C. Drinkwater Jr, B. L. George, J. Yun, M. Salem, and V. Allada Staged surgical approach to neonates with aortic obstruction and single-ventricle physiology Ann. Thorac. Surg., September 1, 1999; 68(3): 962 - 967. [Abstract] [Full Text] [PDF]

				Z. Amin, C. L. Backer, C. E. Duffy, and C. Mavroudis Does banding the pulmonary artery affect pulmonary valve function after the Damus-Kaye-Stansel operation? Ann. Thorac. Surg., September 1, 1998; 66(3): 836 - 841. [Abstract] [Full Text] [PDF]