Carter T L, Mainwaring R D, Lamberti J J
Division of Cardiac Surgery, Children's Hospital and Health Center, San Diego, California.
Ann Thorac Surg. 1994 Dec;58(6):1603-8. doi: 10.1016/0003-4975(94)91641-1.
The Damus-Kaye-Stansel operation is useful in the management of complex congenital heart defects. We reviewed our experience with 23 patients who underwent a Damus-Kaye-Stansel procedure. The anastomotic technique was individualized depending on the anatomy. The aortic and pulmonary artery incisions were carried into the sinuses of Valsalva in 9 patients, the aorta was transected in 11 patients, and a patch was used to augment the anastomosis in 13 patients. Concurrent procedures included a Fontan operation (n = 9, mortality = 0), right ventricle-pulmonary artery conduit (n = 5, mortality = 0), bidirectional Glenn procedure (n = 6, mortality = 1), and central aortopulmonary shunt (n = 3, mortality = 2; emergency = 1). Survival is 87% with a median follow-up of 7 years (range, 2 months to 9.2 years). Four patients underwent late revision of the Damus-Kaye-Stansel connection. All survivors are asymptomatic. We conclude that the Damus-Kaye-Stansel connection provides excellent midterm results when the proximal anastomosis is adapted to the anatomy of the patient.
达穆斯-凯伊-斯坦塞尔手术在复杂先天性心脏缺陷的治疗中很有用。我们回顾了23例接受达穆斯-凯伊-斯坦塞尔手术患者的经验。吻合技术根据解剖结构个体化。9例患者的主动脉和肺动脉切口延伸至主动脉窦，11例患者横断主动脉，13例患者使用补片扩大吻合口。同期手术包括Fontan手术（n = 9，死亡率 = 0）、右心室-肺动脉管道（n = 5，死亡率 = 0）、双向格林手术（n = 6，死亡率 = 1）和中心性主肺动脉分流术（n = 3，死亡率 = 2；急诊手术 = 1）。中位随访7年（范围2个月至9.2年），生存率为87%。4例患者接受了达穆斯-凯伊-斯坦塞尔连接的后期修复。所有存活者均无症状。我们得出结论，当近端吻合口适应患者解剖结构时，达穆斯-凯伊-斯坦塞尔连接可提供良好的中期效果。
