The Damus-Kaye-Stansel (DKS) procedure is a method for mitigating the risk of systemic ventricular outflow tract obstruction (SVOTO). However, there have. Damus-Kaye-Stansel Operation. This procedure usually complements other corrective procedures. It was originally developed along with the Rastelli procedure. Modified Damus-Kaye-Stansel procedure for single ventricle, subaortic stenosis, and arch obstruction in neonates and infants: Midterm results and techniques.
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Author information Article notes Copyright and License information Disclaimer. However, these procedures can cause heart block, ventricular dysfunction, and recurrent stenosis. Later, a modified DKS was reported in which an aortic flap technique was utilized. We decided upon the surgical technique to use for the DKS procedure according to the relationship kaey the aorta and the main pulmonary artery. Bwt, body weight; BSA, body surface area. If the great arteries damsu the relationship of anterior-posterior, we chose the double-barrel technique group Aand if they lay side-by-side, we performed the ascending aorta flap technique group Bwhich is a type of end-to-side DKS procedure with patch augmentation [ 12 ].
There may be complications after the Pulmonary Band Procedure, resulting in obstructions to the flow of blood through the aorta to the body. If the relationship was side-by-side, the ascending aortic flap technique group B was kayd. It is possible to perform the double-barrel technique in the case of a side-by-side relationship, and it is also possible to choose the ascending aorta flap technique in the case of the anterior-posterior relationship.
This narrows the pulmonary artery, which reduces blood flow. Thereafter, a bovine pericardium was used for repairing the anterior defect Fig. Illustration of surgical technique.
This operation was first introduced for biventricular repair in patients with dextro-transposition of the great arteries [ 6 — 8 ]. Further, we followed-up with the postoperative echocardiographic results: All DKS operations were performed by a single surgeon.
Tricuspid atresia, transposition of the great arteries, and banded pulmonary artery: Korean Journal of Thoracic and Cardiovascular Surgery. Retrieved November 16, Only 1 patient had mild preoperative AR, and the rest had a degree of trivial.
The image daus the left illustrates one surgical option – the Damus-Kaye-Stansel Procedure, in which the aorta and pulmonary artery are joined using a patch pink. Clinical outcomes of prophylactic Damus-Kaye- Stansel anastomosis concomitant with bidirectional Glenn procedure.
A comparison between the two groups was performed using the Wilcoxon signed-rank test. The preoperative cardiac diagnosis is summarized in Table 1.
The objective of this study is to kwye the outcomes of stansell DKS procedure according to the surgical technique used from the perspective of neo-aortic regurgitation and recurrent SVOTO, which are considered to be two major complications caused by the DKS procedure [ 12 — 14 ]. Patient characteristics of the two groups. In this case, there was a possibility of the deformation of the shape of the pulmonary sinus at the time of the DKS procedure.
In the original DKS procedure, surgeons separated the main pulmonary artery MPA just below the point where it divides into kayd right and left pulmonary arteries.
We divided the 12 patients into two groups according to the surgical technique used. Modified Damus-Kaye-Stansel procedure using aortic flap technique for systemic ventricular outflow tract obstruction in functionally univentricular heart. Management of univentricular heart with systemic ventricular outflow obstruction by pulmonary artery banding and Damus-Kaye-Stansel operation.
Damus–Kaye–Stansel procedure – Wikipedia
They chose the DKS surgical technique according to the diameter of the ascending aorta. There was no early mortality and 1 late mortality in group B. However, 7 months later, he was admitted via the emergency room owing to general weakness.
Support Center Support Center. In group A, 3 patients underwent the Gore-Tex or polytetrafluoroethylene graft interposition for preserving the shape of the pulmonary sinus, and 1 patient underwent aortopulmonary window creation.
J Thorac Cardiovasc Surg. There were no statistically significant differences between group A and group B in age, body weight, body surface area, duration, and subaortic stenosis at the time of both PAB and the DKS procedure Table 2.
Outcomes of Damus-Kaye-Stansel anastomosis at time of cavopulmonary connection in single ventricle patients at risk of developing systemic ventricular outflow tract obstruction. The results of long-term follow-up remain to be seen.
More than moderate postoperative neoaortic regurgitation was observed in 1 patient of group B; this patient underwent neoaortic valve replacement 66 months after the DKS procedure.
Further, they suggested that an almost equal diameter of the ascending aorta to that of the pulmonary trunk was a good indication for the double-barrel technique. Views Read Edit View history. Further, a significant postoperative pressure gradient was not observed in either group A or group B.
B Ascending aorta flap technique group B. The median peak pressure laye of subaortic stenosis was 15 mmHg range, 0 to 53 mmHg. However, there have been few reports on which surgical technique shows a better outcome. The objective of damu study was to compare the outcome of the DKS procedure according to the surgical technique used. More than a moderate degree of postoperative AR was not seen in any of the 12 patients.
This patient underwent PAB, coarctoplasty, and infracardiac obstructive total anomalous pulmonary venous connection repair before the DKS procedure. It is commonly used when a patient has the combination of a small left ventricle and a transposition of the great wtansel TGA ; in this case, the procedure allows blood to flow from the left ventricle to the aorta.