Damus-Kaye-Stansel Anastomosis for Rapid Progression of Subaortic Stenosis after Pulmonary Artery Banding in a Single Ventricle Infant with Aortic Arch Hypoplasia

(Department of Cardiovascular Surgery, Tsukuba University Hospital, Tsukuba, Japan and Department of Cardiovascular Surgery, Ibaraki Childrenfs Hospital*, Mito, Japan)

Hideyuki Kato Yuji Hiramatsu Yukiko Ban
Mio Noma Shinya Kanemoto* Masakazu Abe*
Yuzuru Sakakibara
A cyanotic baby boy was given a diagnosis of single right ventricle, double outlet right ventricle, hypoplastic aortic arch, mitral atresia, atrial septal defect and pulmonary-ductus-descending aorta trunk. On day 4, extended aortic arch anastomosis and pulmonary artery banding were undertaken. At age 70 days, severe cyanosis and respiratory distress appeared and advanced rapidly. Angiography revealed critical subaortic stenosis and pulmonary hypertension, and the patient required urgent Damus-Kaye-Stansel anastomosis with concomitant right modified Blalock-Taussig shunt. Patients with single ventricle and hypoplastic aortic arch are a high-risk subgroup of progressive subaortic stenosis after initial pulmonary artery banding, and therefore need careful observation and may require early relief of subaortic stenosis.
@Jpn. J. Cardiovasc. Surg. 36: 284-287 (2007)