Modification of the Damus-Kaye-Stansel procedure.

The Damus-Kaye-Stansel procedure and its modifications have been performed to relieve systemic outflow tract obstruction in patients with a functional single ventricle. However, distortion of the pulmonary valve and sinus in the original procedure may cause pulmonary valve incompetence to develop, and prosthetic material is frequently required due to the size discrepancy between the newly reconstructed proximal great artery stump and the ascending aorta in recent modifications. We performed the Damus-Kaye-Stansel procedure with some technical modifications to overcome these concerns in 2 children and observed a competent pulmonary valve and a patent Damus-Kaye-Stansel pathway at the latest follow-up.