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J Thorac Cardiovasc Surg 1996;111:904
© 1996 Mosby, Inc.

LETTERS TO THE EDITOR

Relief of aortic obstruction in {S,L,L} hearts with rudimentary right ventricle and restrictive bulboventricular foramen

Richard P. Embrey, MD

Pediatric Cardiac Surgery Service
West Hospital
Richmond, VA 23298-0068

To the Editor:

Van Son and associatesGo 1 have nicely described a small series of neonates with double-inlet left ventricle and a restrictive bulboventricular foramen that was relieved by a modification of the Damus-Stansel-Kaye procedure. I agree completely with their conclusion that using a posteriorly based flap of aortic wall to construct the anastomosis between the proximal pulmonary artery and the ascending aorta is useful. However, this modification was first described by Dr. Hillel Laks in 1992.Go 2

I personally find this technique particularly useful when the Damus procedure is necessary in a patient with normally related great arteries because of the avoidance of a long posterior suture line on the left side of the aorta. Unlike the more traditional technique of the Damus-Stansel-Kaye procedure, in which an incision is often made into the pulmonary valve sinus, this technique also minimizes distortion to the pulmonic valve and may lead to improved long-term function of that valve.

References

  1. Van Son J, Reddy V, Haas G, Hanley F. Modified surgical techniques for relief of aortic obstruction in {S,L,L} hearts with rudimentary right ventricle and restrictive bulboventricular foramen. J THORAC CARDIOVASC SURG1995;110:909-15.
  2. Laks H, Gates R, Elami A, Pearl J. Damus-Stansel-Kaye procedure: technical modifications. Ann Thorac Surg 1992;54:166-8.[Abstract]




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