title: Damus anastomosis associated with REV/Rastelli procedure allows to extend indications for anatomical repair in complex transposition of great arteries.
abstract: We report here the indications and the results of a surgical option associating a Damus procedure with a 'Réparation à l'Etage Ventriculaire' (REV)/Rastelli procedure, for anatomical repair of patients presenting with complex transposition of great arteries (TGA), restrictive/remote ventricular septal defect (VSD) and pulmonary stenosis (PS). Five consecutive patients (median age: 11 months (range: 20 days to 15 years)) presenting with complex TGA-VSD-PS and anatomical lesions resulting in a contraindication to a Nikaidoh procedure were included. Two of them presented with a postoperative restrictive left ventricle-to-aorta baffle and secondarily underwent a modified Damus procedure a few days after the REV or Rastelli procedure. In the other 3 patients, the Damus procedure was primarily performed at the time of the REV or Rastelli procedure. No death occurred. At the last follow-up (mean: 31 ± 37 months), all patients displayed an excellent functional status and an unobstructed left ventricular outflow tract in echocardiography. Associating a Damus procedure with a REV/Rastelli procedure can be considered as an effective and low-risk surgical option to extend the indications for anatomical repair in patients with complex TGA-VSD-PS and anatomical findings precluding other surgical options.
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital, Le Plessis Robinson, France University of Medicine Paris Sud, le Kremlin-Bicêtre, France dk2757@cumc.columbia.edu.
authors.forename: David
authors.initials: D
authors.lastname: Kalfa
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital, Le Plessis Robinson, France University of Medicine Paris Sud, le Kremlin-Bicêtre, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Vergnat
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital, Le Plessis Robinson, France University of Medicine Paris Sud, le Kremlin-Bicêtre, France.
authors.forename: Alban-Elouen
authors.initials: AE
authors.lastname: Baruteau
authors.affiliation: Department of Pediatric and Congenital Heart Disease, Marie Lannelongue Hospital, Le Plessis Robinson, France University of Medicine Paris Sud, le Kremlin-Bicêtre, France.
authors.forename: Emre
authors.initials: E
authors.lastname: Belli
mesh_terms: D000293:Adolescent; D000714:Anastomosis, Surgical; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011666:Pulmonary Valve Stenosis / Q000150:complications / Q000601:surgery; D014188:Transposition of Great Vessels / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Biventricular repair; Complex congenital heart disease; Damus–Kay–Stansel anastomosis; Rastelli procedure; Réparation à l'Etage Ventriculaire; Transposition of great arteries