title: Damus-Kaye-Stansel Procedure with Extracardiac Fontan: Successful Recruitment of Previously Ligated Pulmonary Valve.
abstract: We present a case of a 2.5-year-old-girl with complex congenital heart disease: tricuspid atresia (TA), bulboventricular septal defect (VSD), hypoplastic right ventricle, d-transposition of the great arteries (d-TGA) with aortic outflow from redundant RV. Due to II/III degree atrioventricular block induced after diagnostic cardiac catheterization, an epicardial pacemaker was implanted during the Glenn procedure. Because of severe left ventricle outflow tract obstruction, she was finally referred for extracardiac TCPC (extracardiac Fontan type) with recruitment of PV and Damus-Kaye-Stansel anastomosis. Intraoperatively, the pulmonary trunk stump was opened and a competent pulmonary valve with flaccid leaflets was found. Simple ligation of the pulmonary trunk with a preserved pulmonary valve enabled an effective aorto-pulmonary bridging of systemic outflow tract with the use of natural fully competent ventricle-arterial valves. The relief of single ventricle outflow tract obstruction led to final stabilization of spontaneous sinus rhythm recovery after 2 years of pacemaker stimulation.
authors: Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdańsk, Poland.
authors: Konrad
authors: K
authors: Paczkowski
authors: Department of Physiotherapy, Faculty of Rehabilitation and Kinesiology, Gdańsk University of Physical Education and Sport, Gdańsk, Poland.
authors: Ireneusz
authors: I
authors: Haponiuk
authors: Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdańsk, Poland.
authors: Maciej
authors: M
authors: Chojnicki
authors: Department of Pediatric Cardiac Surgery, Mikolaj Kopernik Hospital in Gdańsk, Poland.
authors: Radosław
authors: R
authors: Jaworski
mesh_terms: D000015:Abnormalities, Multiple; D006328:Cardiac Catheterization / Q000379:methods*; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D018729:Fontan Procedure / Q000379:methods*; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008026:Ligation; D011664:Pulmonary Valve / Q000601:surgery*