DAMUS-KAYE-STANSEL PROCEDURE - MIDTERM FOLLOW-UP AND TECHNICAL CONSIDERATIONS

The Damus-Kaye-Stansel operation is useful in the management of comple x congenital heart defects. We reviewed our experience with 23 patient s who underwent a Damus-Kaye-Stansel procedure. The anastomotic techni que was individualized depending on the anatomy. The aortic and pulmon ary artery incisions were carried into the sinuses of Valsalva in 9 pa tients, the aorta was transected in 11 patients, and a patch was used to augment the anastomosis in 13 patients. Concurrent procedures inclu ded a Fontan operation (n = 9, mortality = 0), right ventricle-pulmona ry artery conduit (n = 5, mortality = 0), bidirectional Glenn procedur e (n = 6, mortality = 1), and central aortopulmonary shunt (n = 3, mor tality = 2; emergency = 1). Survival is 87% with a median follow-up of 7 years (range, 2 months to 9.2 years). Four patients underwent late revision of the Damus-Kaye-Stansel connection. All survivors are asymp tomatic. We conclude that the Damus-Kaye-Stansel connection provides e xcellent midterm results when the proximal anastomosis is adapted to t he anatomy of the patient.