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

This Article Full Text Full Text (PDF) 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): Christian P.R. Brizard Andrew D. Cochrane Tom R. Karl Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Broekhuis, E. Articles by Karl, T. R. Search for Related Content PubMed PubMed Citation Articles by Broekhuis, E. Articles by Karl, T. R.

Ann Thorac Surg 1999;67:519-521
© 1999 The Society of Thoracic Surgeons

---

Original Articles

Damus-Kaye-Stansel connections in children with previously transected pulmonary arteries

^a Cardiac Surgical Unit, Royal Children’s Hospital, Melbourne, Australia

Accepted for publication July 9, 1998.

Address reprint requests to Dr Karl, Cardiac Surgical Unit, Royal Children’s Hospital, Flemington Rd, Parkville, 3052, Victoria, Australia

Background. In patients with a univentricular arteriovenous connection, transection of the main pulmonary artery may be performed as part of a bidirectional cavopulmonary shunt or Fontan procedure. The proximal stump of the pulmonary artery may remain in the systemic circulation. In cases with a discordant ventriculoarterial connection, subsequent restriction of the bulboventricular foramen may lead to subaortic stenosis. The subaortic stenosis can be corrected in some patients by directing the systemic flow through a combined nonobstructed aortopulmonary outlet, as in the Damus-Kaye-Stansel connection. Previous closure of the pulmonary artery has been considered by some investigators to be a relative contraindication to the Damus-Kaye-Stansel procedure, unless an allograft root can be added to the circuit after excision of the closed pulmonary stump.

Methods. Three patients with previously transected pulmonary arteries underwent a modified Damus-Kaye-Stansel connection using the native pulmonary valve and the proximal pulmonary artery stump.

Results. The native pulmonary valves have functioned well despite thrombus formation in the proximal stump in 2 patients before Damus conversion. All 3 patients are alive and well after 108, 19, and 3 months, with competent nonobstructed ventriculoarterial connections.

Conclusions. If transection and closure of the pulmonary artery as part of a previous palliation has spared the pulmonary valve, then the native pulmonary outlet might be used for a safe Damus-Kaye-Stansel connection.

This article has been cited by other articles:

				A. J. B. Clarke, S. Kasahara, D. R. Andrews, S. G. Cooper, I. A. Nicholson, R. B. Chard, G. R. Nunn, and D. S. Winlaw Mid-Term results for double inlet left ventricle and similar morphologies: timing of Damus-Kaye-Stansel Ann. Thorac. Surg., August 1, 2004; 78(2): 650 - 657. [Abstract] [Full Text] [PDF]

				T. Miura, H. Kishimoto, H. Kawata, M. Hata, T. Hoashi, and T. Nakajima Management of univentricular heart with systemic ventricular outflow obstruction by pulmonary artery banding and Damus-Kaye-Stansel operation Ann. Thorac. Surg., January 1, 2004; 77(1): 23 - 28. [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]