Improved Long-term Outcome of Damus-Kaye-Stansel Procedure Without Previous Pulmonary Artery Banding.

Kido, Takashi; Steringer, Maria-Theresa; Vodiskar, Janez; Burri, Melchior; Ewert, Peter; Strbad, Martina; Cleuziou, Julie; Hager, Alfred; Hörer, Jürgen; Ono, Masamichi

doi:10.1016/j.athoracsur.2021.05.022

Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum

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Title:: Improved Long-term Outcome of Damus-Kaye-Stansel Procedure Without Previous Pulmonary Artery Banding.
Document type:: Journal Article
Author(s):: Kido, Takashi; Steringer, Maria-Theresa; Vodiskar, Janez; Burri, Melchior; Ewert, Peter; Strbad, Martina; Cleuziou, Julie; Hager, Alfred; Hörer, Jürgen; Ono, Masamichi
Abstract:: BACKGROUND: This study sought to determine long-term outcomes of a primary Damus-Kaye-Stansel (DKS) procedure in patients with a functional single ventricle and to compare the results with those of our historical control subjects who underwent pulmonary artery banding before the DKS procedure. METHODS: The study reviewed the medical records of all patients who underwent the DKS procedure at the German Heart Center of Munich, Germany between December 1994 and December 2019. RESULTS: The DKS procedure was performed as initial palliation in 52 patients (primary DKS group) and as staged palliation after pulmonary artery banding in 24 patients (staged DKS group). The median follow-up period after the DKS procedure was 8.9 years in the primary DKS group and 8.0 years in the staged DKS group. The survival rates at 10 years after the DKS procedure were 89% in the primary DKS group and 68% in the staged DKS group (log-rank P = 0.04). Before total cavopulmonary connection, the pressure gradient through the systemic ventricular outflow tract was significantly lower in the primary DKS group than in the staged DKS group (P < .001). At last follow-up echocardiography, reduced ventricular function was observed in 1 patient in the primary DKS group and in 7 patients in the staged DKS group (P < .001). The degree of neoaortic regurgitation was significantly higher in the staged DKS group than in the primary DKS group (P < .001). CONCLUSIONS: A primary DKS procedure in patients with a functional single ventricle and potential systemic ventricular outflow tract obstruction is recommended to obtain favorable long-term survival with preserved ventricular function and competent semilunar valve function.
Journal title abbreviation:: Ann Thorac Surg
Year:: 2022
Journal volume:: 114
Journal issue:: 2
Pages contribution:: 545-551
Fulltext / DOI:: doi:10.1016/j.athoracsur.2021.05.022
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/34087235
Print-ISSN:: 0003-4975
TUM Institution:: Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (Prof. Hörer); Klinik für Herz- und Gefäßchirurgie (Prof. Lange); Klinik für Kinderkardiologie und angeborene Herzfehler (Prof. Ewert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert)2022

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Chirurgie angeborener Herzfehler und Kinderherzchirurgie (DHM) (Prof. Hörer)2022

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane)2022