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Ann Thorac Surg 1993;56:111-119
© 1993 The Society of Thoracic Surgeons

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Articles

Damus-Stansel-Kaye procedure: Current indications and results

Division of Cardiothoracic Surgery, Department of Surgery, and Division of Pediatric Cardiology, Department of Pediatrics, UCLA Medical Center, Los Angeles, California USA

Accepted for publication October 15, 1992.

^_* Address reprint requests to Dr Laks, Division of Cardiothoracic Surgery, UCLA Medical Center, CHS 62-182, 10833 LeConte Ave, Los Angeles, CA 90024.

Between October 1983 and August 1991, 29 consecutive Damus-Stansel-Kaye procedures were performed. Indications for operation included restrictive bulboventricular foramen or subaortic stenosis associated with complex univentricular congenital heart disease (25) and Taussig-Bing heart, subaortic stenosis, or both associated with complex biventricular congenital heart disease (4). Twelve patients underwent concurrent Fontan procedures. Average age at operation was 39.8 months (range, 1 to 132 months). Average outflow tract gradient was 28 mm Hg (range, dynamic to 80 mm Hg). Of the 29 patients, 23 were male and 6 were female. There were three early deaths (10%), two in patients who had a concurrent Fontan procedure. Although there was a trend toward lower age and higher outflow tract gradients in nonsurvivors, these and other factors were not statistically significant predictors of death. Actuarial freedom from cardiac-related death was 88%. at 5 years (n = 7). In a mean follow-up of 3.5 years (range, 0.1 to 7.7 years), 3 patients have required reoperation (10%), 2 for aortic valve insufficiency (5 days and 2.75 years) and 1 for a gradient across the anastomosis (5.75 years). Actuarial freedom from reoperation related to a failed Damus-Stansel-Kaye procedure was 90% at 4 years and 75% at 6 years (n = 7).

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