Rastelli procedure

The Rastelli procedure is an open heart surgical procedure developed by Italian physician and cardiac surgery researcher, Giancarlo Rastelli in 1967 at the Mayo Clinic and involves using a pulmonary or aortic homograft conduit to relieve pulmonary obstruction in double outlet right ventricle with pulmonary stenosis.

Rastelli procedure
Specialtycardiology

Usage

It is used to correct certain combinations of congenital heart defects (CHDs):

  1. dextro-Transposition of the great arteries (d-TGA), or overriding aorta, or double outlet right ventricle (DORV); and
  2. Ventricular septal defect (VSD); and
  3. Right ventricular outflow tract obstruction (RVOTO):

Timing

The Rastelli procedure is typically performed between one and two years of age. Since d-TGA, overriding aorta, and DORV are cyanotic heart defects, the child is palliated with a Blalock-Taussig shunt in the meantime.

Method

A Gore-Tex patch is used to direct oxygenated blood from the left ventricle to the aorta, while at the same time closing the VSD. The pulmonary valve is surgically closed and an artificial conduit and valve are constructed from the right ventricle to the pulmonary bifurcation, allowing oxygen depleted blood to travel to the lungs for reoxygenation.

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References
    • Rastelli, G. C.; McGoon, D. C.; Wallace, R. B. (October 1969). "Anatomic correction of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis". The Journal of Thoracic and Cardiovascular Surgery. 58 (4): 545–552. doi:10.1016/s0022-5223(19)42568-3. ISSN 0022-5223. PMID 5387997.


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