title: Treatment of subaortic stenosis in hearts with single-ventricle physiology.
abstract: BACKGROUND
  We evaluated the patients who had had a Damus-Kaye-Stansel (DKS) operation for single-ventricular physiology with the aorta originating from a hypoplastic ventricle and the pulmonary artery from the systemic ventricle.
  
  
  METHODS
  Seven patients who were operated on between May 2007 and November 2010 were evaluated retrospectively. The patients had been diagnosed with a transposed double-inlet left ventricle and triscuspid atresia, and  had  been  waiting for a Fontan operation. Systemic outflow stenosis was defined echocardiographically as those with a gradient greater than 20 mmHg, and angiographically those with greater than 5 mmHg in the subaortic region.
  
  
  RESULTS
  The mean age and weight of the patients was 15 ± 9.7 months and 8 ± 3.3 kg, respectively. The mean gradient between the systemic ventricle and the aorta was 35 ± 25 mmHg. This gradient decreased to 14.3 ± 4 mmHg postoperatively. The early hospital mortality was 14% (one patient). The mean extubation time and mean time in the intensive care unit (ICU) were 13 ± 7.3 hours and 2.2 ± 0.5 days, respectively. The mean follow-up time was 11 ± 2 months. No mortality and semi-lunar valve insufficiency were observed after discharge.
  
  
  CONCLUSIONS
  One of the major problems that occur while waiting for a Fontan operation is systemic ventricular hypertrophy and deterioration in the compliance of the ventricle due to systemic ventricular outflow stenosis. When the disadvantages of outflow resection are encountered, a DKS proves to be a good alternative.
authors.affiliation: Department of Cardiovascular Surgery, Baskent University Hospital, Istanbul, Turkey. bsaritas@hotmail.com
authors.forename: Bulent
authors.initials: B
authors.lastname: Saritas
authors.forename: Emre
authors.initials: E
authors.lastname: Ozker
authors.forename: Can
authors.initials: C
authors.lastname: Vuran
authors.forename: Çağri
authors.initials: Ç
authors.lastname: Gunaydin
authors.forename: Canan
authors.initials: C
authors.lastname: Ayabakan
authors.forename: Riza
authors.initials: R
authors.lastname: Turkoz
mesh_terms: D001011:Aorta / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014694:Ventricular Outflow Obstruction / Q000503:physiopathology / Q000601:surgery*