title: Risk Factors for Semilunar Valve Insufficiency After the Damus-Kaye-Stansel Procedure.
abstract: BACKGROUND
  Cardiac function and survival after the Damus-Kaye-Stansel (DKS) procedure are encouraging, but only limited data exist related to postprocedural semilunar valve function. We investigated postprocedural midterm to long-term outcomes and changes in semilunar valve function and identified risk factors of semilunar valve function deterioration.
  
  
  METHODS
  Between 1996 and 2012, 63 patients with a single functional ventricle underwent the DKS procedure. Of them, 50 had previously undergone pulmonary artery banding. Cardiac function was measured by catheter examination 5.3 months (interquartile range, 2.6 to 9.7) preoperatively and 1.2 years (interquartile range, 1.0 to 1.4) postoperatively. Echocardiographic examination of the semilunar valve was performed concurrently with the catheter examination and at the last follow-up (5.3 years [interquartile range, 3.1 to 9.2] postoperatively).
  
  
  RESULTS
  The overall survival rate at 1, 5, and 10 years postoperatively was 0.97, 0.92, and 0.89, respectively. Aortic and pulmonary valve regurgitation grade 1 year postoperatively and at the last follow-up increased compared with the preoperative grade. There was no significant difference between regurgitation at 1 year and the last follow-up. The duration from pulmonary artery banding to the DKS procedure was longer in the group with at least mild regurgitation (n = 6) than in the group with less than mild regurgitation (n = 54).
  
  
  CONCLUSIONS
  Although the duration from pulmonary artery banding to the DKS procedure was associated with postoperative regurgitation, neither postprocedural aortic nor pulmonary valve regurgitation increased over time, and there were no deleterious effects on the clinical conditions.
authors.affiliation: Department of Cardiovascular Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan; Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan. Electronic address: sanae-y@nyc.odn.ne.jp.
authors.forename: Sanae
authors.initials: S
authors.lastname: Yamauchi
authors.affiliation: Department of Cardiovascular Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawata
authors.affiliation: Department of Cardiovascular Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Shigemitsu
authors.initials: S
authors.lastname: Iwai
authors.affiliation: Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Kayatani
authors.affiliation: Department of Cancer Epidemiology and Community Health, Hirosaki University Graduate School of Medicine, Aomori, Japan; Department of Medical Informatics, Hirosaki University Hospital, Aomori, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Matsuzaka
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Fukuda
authors.affiliation: Department of Cardiovascular Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kishimoto
mesh_terms: D001022:Aortic Valve Insufficiency / Q000453:epidemiology* / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002675:Child, Preschool; D006801:Humans; D011665:Pulmonary Valve Insufficiency / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors