Damus-Kaye-Stansel procedure avoids coronary obstruction in complex D-transposition

Abstract

Although all coronary anatomy in D‐transposition of the great arteries may be “switchable,” there are reports in the literature of early and late coronary obstruction following the arterial switch operation. The Damus‐Kaye‐Stansel procedure does not risk injury to the coronary arteries, and unlike the atrial switch, commits the left ventricle to the systemic circulation. We present a series of four neonates over 22 years with D‐transposition of the great arteries and a concomitant coronary artery anomaly precluding arterial switch that were repaired using a Damus‐Kaye‐Stansel procedure and right ventricle to pulmonary artery conduit.

Surgical treatment for the single ventricle with subaortic obstruction. Clinical case of the Damus-Kaye-Stansel procedure

“…Today, the procedure is most often used when there is an obstruction to system outflow with a single ventricle, although it was not used in this quality in the original description [2]. The advantages of performing DKS are: the ability to adequately address most cases of obstruction of the systemic blood flow, perform arc reconstruction, and a low risk of developing heart block [3,4]. Two main methods of DKS are described: creating an anastomosis between the pulmonary artery trunk and the aorta in an "end-to-side" anastomosis and an "end-to-end" anastomosis (modification "double-barrel").…”