Long-Term Outcome of Direct Relief of Subaortic Stenosis in Single Ventricle Patients

Direct relief of subaortic stenosis in single ventricle patients via ventricular septal defect/subaortic chamber enlargement has been mostly replaced by the Damus-Kaye-Stansel/Norwood procedure due to concerns for potential re-obstruction or heart block. However, little is known about long-term outcome. Among 23 single ventricle patients (median age: 7.4 months, range: 10 days to 5.5 years) who underwent direct relief of subaortic stenosis at Leiden University Medical Center (1989-2016), authors observed a high risk of re-obstruction and patch (pseudo)aneurysm formation. However, risk of heart block was low, and the majority of patients underwent Fontan completion successfully. In selected patients, the direct approach can be a relatively simple and safe procedure.