Experience with the Damus-Kaye-Stansel procedure for children with Taussig-Bing hearts or univentricular hearts with subaortic stenosis.

Abstract

Anastomosis of the pulmonary artery to the ascending aorta is the essence of a technique for repair of complete transposition proposed by Damus, Kaye, and Stansel. Our Institutional experience with the Damus-Kaye-Stansel procedure (DKS) is limited to 9 children with double-outlet right ventricle and 38 with univentricular heart plus subaortic stenosis. Thirty-eight children (81%) survived the DKS procedure, and there were three late deaths during the mean follow-up of 3.1 years. Five-year survival is 72% (+/- 8%). All six children surviving a DKS and biventricular repair of double-outlet right ventricle have required conduit replacement at a mean interval of 46 months. In the children with univentricular heart, relief of subaortic stenosis with the DKS was successful in all except two. The late function of the semilunar valves is of concern, as 36% of the aortic and 52% of the pulmonary valves have some degree of incompetence.