Damus-Kay-Stansel procedure with ventricular septal defect enlargement

Area of Science:

• Pediatric Cardiology
• Congenital Heart Surgery
• Cardiovascular Medicine

Background:

• Infants with complex congenital heart disease, including tricuspid atresia and transposed great arteries, often face progressive cyanosis.
• Subpulmonary stenosis can worsen, significantly impacting patient outcomes and requiring timely intervention.

Purpose of the Study:

• To describe a surgical approach for complex congenital heart disease with progressive subpulmonary stenosis.
• To evaluate the efficacy of the Damus-Kay-Stansel procedure and bidirectional Glenn shunt in this patient population.

Main Methods:

• Surgical intervention included the Damus-Kay-Stansel procedure and bidirectional Glenn shunt.
• Ventricular septal defect enlargement and resection of conus septum with fibrous tissue were performed without ventriculotomy.
• Postoperative assessment utilized echocardiography to evaluate surgical outcomes.

Main Results:

• The surgical procedure successfully enlarged the ventricular septal defect and subpulmonary space.
• Effective relief of subpulmonary stenosis was achieved, leading to improved cyanosis.
• No semilunar valve regurgitation was observed postoperatively.

Conclusions:

• The combined surgical approach is effective in managing complex congenital heart disease with progressive subpulmonary stenosis.
• This technique offers a viable option for improving cyanosis and relieving obstruction in affected infants.
• Minimally invasive techniques, avoiding ventriculotomy, can be successfully applied in complex pediatric cardiac surgeries.