Damus-Stansel-Kaye procedure: current indications and results

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• The Damus-Stansel-Kaye procedure is a palliative surgical technique used for complex congenital heart disease.
• It addresses conditions such as restrictive bulboventricular foramen and subaortic stenosis.

Purpose of the Study:

• To evaluate the outcomes of the Damus-Stansel-Kaye procedure in patients with complex univentricular and biventricular congenital heart disease.
• To assess early mortality, long-term survival, and reoperation rates.

Main Methods:

• A retrospective review of 29 consecutive Damus-Stansel-Kaye procedures performed between October 1983 and August 1991.
• Analysis of patient demographics, indications for surgery, concurrent procedures (including Fontan procedure), age at operation, outflow tract gradients, and follow-up data.

Main Results:

• Three early deaths (10%) occurred, with two in patients who also had a concurrent Fontan procedure.
• Actuarial freedom from cardiac-related death was 88% at 5 years.
• Ten percent of patients required reoperation, primarily for aortic valve insufficiency or gradient across the anastomosis, with 90% freedom from reoperation related to the Damus-Stansel-Kaye procedure at 4 years.

Conclusions:

• The Damus-Stansel-Kaye procedure demonstrates acceptable early and long-term outcomes for selected patients with complex congenital heart disease.
• While reoperations may be necessary, the procedure offers a viable option for palliation, with good survival rates and manageable reoperation risks.