The Damus-Kaye-Stansel 0peration: Management of systemic ventricular outflow tract obstruction

The Damus-Kaye-Stansel (DKS) anastomosis was originally described for the treatment of transposition of the great arteries but it is now used mainly for the treatment of single ventricle anomalies in patients who are at risk of developing systemic ventricular outflow tract obstruction (SVOTO). In most instances, DKS is performed as a concomitant procedure at time of bidirectional cavopulmonary connection in these patients. This tutorial we demonstrate our modified double-barrel approach, along with anterior patch augmentation of the distal ascending aorta. We have found that this technique is very effective in mitigating SVOTO risk while preserving semilunar valve anatomy and function.