Univentricular heart with systemic outflow obstruction: Palliation by primary Damus procedure

摘要: In 24 consecutive infants (19 male and 5 female) with complex forms of single-ventricle physiology systemic outflow obstruction, a modified Damus operation without the use exogenous material was undertaken in conjunction creation an aortopulmonary shunt 3.5 mm diameter. The median age at 6 days (range, 1 to 170 days) weight, 3.4 kg 2.6 4.6 kg). There were nine early deaths. All 15 survivors (median follow-up, 6.5 months) clinically well major ventricular dysfunction or atrioventricular arterial valve regurgitation. Ten them have undergone superior vena cava—pulmonary (one death), has required patch angioplasty aortic arch innominate artery revision shunt. 4 other are awaiting cavopulmonary Univariate analysis yielded chronologic rank for individual procedure (higher risk death series), presence atresia, absence transposition great arteries as predictors death. This aggressive surgical approach provides excellent palliation, because prevents abnormal hypertrophy from pressure volume overload, function is optimally conserved future Fontan-type procedure.