The Rastelli operation was initially utilized for the repair of d-transposition of the great vessels with ventricular septal defect and pulmonary stenosis. It has subsequently been utilized for a variety of congenital heart defects characterized by two ventricles and overriding of the aorta with severe pulmonary stenosis (PS) or pulmonary atresia.
From July 2007 to December 2008, seven patients underwent correction of heart defects with rastelli procedure. Patients were aged from 4 month to 7 year, and four patients were female.
In all cases right ventriculotomy were made to repair the VSD with a Dacron patch by creating an intraventricular tunnel between the left ventricle and the aorta. The main pulmonary artery was divided and the proximal end was closed. A homograft conduit was implanted between the right ventricle and the main pulmonary artery. (Three of them were Labcor Stentless Valved Pulmonary Conduit and four of them were Contegra Pulmonary Bovine Conduit)
The Rastelli procedure can completely correct the right ventricular outflow tract stenosis, and right to left shunt, and avoid injuring the right coronary artery. It is a long and complex surgical procedure. It involves extensive and invasive monitoring of the patient before, during and after the operation. This includes catheters in a vein, an artery and the left atrium. Additionally, various medications will be used as necessary to alter the workload of the heart and blood vessels.
Satisfactory postoperative hemodynamics are dependent upon free, unobstructed egress of blood from both the left ventricle and the right ventricle.