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The Damus-Fontan procedure.

J J Lamberti1, R D Mainwaring, J D Waldman

  • 1Division of Cardiac Surgery, Children's Hospital, San Diego, California.

The Annals of Thoracic Surgery
|September 1, 1991
PubMed
Summary
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The Damus-Kaye-Stansel operation and its modifications are effective for complex cyanotic heart disease. Surgical outcomes for the Damus-Fontan and Damus-cavopulmonary shunt procedures show good to excellent long-term results.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Complex cyanotic congenital heart disease often requires surgical palliation.
  • Obstruction between the systemic ventricle and aorta presents a significant surgical challenge.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the Damus-Kaye-Stansel operation and its modifications.
  • To assess the results of the Damus-Fontan and Damus-cavopulmonary shunt procedures in patients with complex cyanotic heart disease.

Main Methods:

  • The study involved surgical modifications of the Damus-Kaye-Stansel operation.
  • Procedures included aortic and pulmonary artery transection, anastomosis, and great artery connection.
  • The bidirectional cavopulmonary shunt and Fontan procedure were utilized in conjunction with the Damus-Kaye-Stansel operation.

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Main Results:

  • Six patients underwent the Damus-Fontan operation, with all surviving.
  • Two patients underwent the Damus-cavopulmonary shunt (hemi-Fontan) procedure, with one survivor.
  • Postoperative status for all seven survivors was reported as good to excellent, with follow-up ranging from 2 months to 7.5 years.

Conclusions:

  • The Damus-Kaye-Stansel operation and its modifications are a viable surgical option for complex cyanotic congenital heart disease.
  • The Damus-Fontan procedure demonstrated excellent survival and postoperative status in this cohort.
  • Further investigation into the Damus-cavopulmonary shunt procedure may be warranted.