HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Christian Kreutzer John E. Mayer, Jr Richard Jonas Pedro J. del Nido Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kreutzer, C. Articles by del Nido, P. J. Search for Related Content PubMed PubMed Citation Articles by Kreutzer, C. Articles by del Nido, P. J.

J Thorac Cardiovasc Surg 2000;120:211-223
© 2000 The American Association for Thoracic Surgery

Surgery for congenital heart disease

Twenty-five–year experience with Rastelli repair for transposition of the great arteries

From the Departments of Cardiology and Cardiac Surgery, Children’s Hospital and Harvard Medical School, Boston, Mass.

Address for reprints: Pedro J. del Nido, MD, Department of Cardiac Surgery, Children’s Hospital, 300 Longwood Ave, Boston, MA 02115 (E-mail: delnido{at}a1.tch.harvard.edu ).

Objective: Our purpose was to describe the outcome of the Rastelli repair in D -transposition of the great arteries and to determine the risk factors associated with unfavorable events.
Methods: From March 1973 to April 1998, 101 patients with D -transposition of the great arteries and ventricular septal defect underwent a Rastelli type of repair. Median age and weight were 3.1 years (10th to 90th percentiles 0.3-9.9 years) and 12.8 kg (5.9-28.2). Pulmonary stenosis was present in 73 patients and pulmonary atresia in 18; 10 patients had no left ventricular outflow tract obstruction.
Results: There were 7 early deaths (7%) and no operative deaths in the last 7 years of the study. Risk factors for early death, by univariable analysis, included straddling tricuspid valve (P = .04) and longer aortic crossclamping times (P = .04). At a median follow-up of 8.5 years, there were 17 late deaths and 1 patient had undergone heart transplantation. Forty-four patients had reoperations for conduit stenosis, 11 for left ventricular outflow tract obstruction, and 28 had interventional catheterization to relieve conduit stenosis. Nine patients had late arrhythmias, and there were 5 sudden deaths. Overall freedom from death or transplantation (Kaplan-Meier) was 82%, 80%, 68%, and 52% at 5, 10, 15, and 20 years, respectively. Freedom from death or reintervention (catheterization or surgical treatment) was 53%, 24%, and 21% at 5, 10, and 15 years of follow-up, respectively.
Conclusions: The Rastelli repair can be performed with low early mortality. However, substantial late morbidity and mortality are associated with conduit obstruction, left ventricular outflow tract obstruction, and arrhythmia.

This article has been cited by other articles:

				F. Jacques, Y. Kotani, D. P. Deva, T. Moller, E. Oechslin, E. Horlick, M. Osten, A. Crean, L. N. Benson, B. J. Wintersperger, et al. Left Main Coronary Artery Compression Long Term After Repair of Conotruncal Lesions: The Bow String Conduit Ann. Thorac. Surg., July 1, 2012; 94(1): 283 - 285. [Abstract] [Full Text] [PDF]

				J. P. da Silva, L. d. F. da Silva, L. M. Lopes, L. F. Moreira, L. F. Caneo, S. M. Franchi, A. C. Lianza, J. F. Baumgratz, and J. Duarte Flavio Magalhaes Pulmonary root translocation in malposition of great arteries repair allows right ventricular outflow tract growth J. Thorac. Cardiovasc. Surg., June 1, 2012; 143(6): 1292 - 1298. [Abstract] [Full Text] [PDF]

				M. Fang, H. Wang, H. Zhu, Z. Wang, X. Li, N. Zhang, and Y. Jin Half rotation of the truncus arteriosus plus arterial switch for transposition of the great arteries with ventricular septal defect and pulmonary outflow tract obstruction Eur J Cardiothorac Surg, September 1, 2011; 40(3): 579 - 583. [Abstract] [Full Text] [PDF]

				D. Metras, V. Fouilloux, L. Mace, A. Fraisse, and B. Kreitmann Right ventricular outflow repair: the aortic autograft technique procures the best late results in the transposition complex Eur J Cardiothorac Surg, September 1, 2011; 40(3): 614 - 618. [Abstract] [Full Text] [PDF]

				D. Di Carlo, B. Tomasco, L. Cohen, P. Vouhe, and Y. Lecompte Long-term results of the REV (reparation a l'etage ventriculaire) operation J. Thorac. Cardiovasc. Surg., August 1, 2011; 142(2): 336 - 343. [Abstract] [Full Text] [PDF]

				K. Miyaji, K. Itatani, N. Inoue, and M. Ishii Half-turned truncal switch operation for transposition of great arteries with ventricular septal defect and pulmonary regurgitation Interact CardioVasc Thorac Surg, August 1, 2011; 13(2): 217 - 219. [Abstract] [Full Text] [PDF]

				J. W. Brown, M. Ruzmetov, D. Huynh, M. D. Rodefeld, M. W. Turrentine, and A. C. Fiore Rastelli Operation for Transposition of the Great Arteries With Ventricular Septal Defect and Pulmonary Stenosis Ann. Thorac. Surg., January 1, 2011; 91(1): 188 - 194. [Abstract] [Full Text] [PDF]

				T. Hoashi, E. L. Bove, E. J. Devaney, J. C. Hirsch, and R. G. Ohye Intermediate-term clinical outcomes of primary biventricular repair for left ventricular outflow tract obstruction and ventricular septal defect J. Thorac. Cardiovasc. Surg., January 1, 2011; 141(1): 200 - 206. [Abstract] [Full Text] [PDF]

				M. G. Hazekamp, A. A. Gomez, D. R. Koolbergen, V. Hraska, D. R. Metras, I. P. Mattila, W. Daenen, H. E. Berggren, J.-E. Rubay, G. Stellin, et al. Surgery for transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction: European Congenital Heart Surgeons Association multicentre study Eur J Cardiothorac Surg, December 1, 2010; 38(6): 699 - 706. [Abstract] [Full Text] [PDF]

				R. Turkoz, C. Ayabakan, C. Vuran, O. Omay, and K. Tokel Arterial Switch and Modified Konno Procedure With Detachment of the Aortic Root for Transposition of the Great Arteries and Left Ventricular Outflow Tract Obstruction Ann. Thorac. Surg., August 1, 2010; 90(2): 683 - 685. [Abstract] [Full Text] [PDF]

				K. Weyand, C. Haun, H. Blaschczok, N. Goetz-Toussaint, J. Photiadis, N. Sinzobahamvya, B. Asfour, and V. Hraska Surgical Treatment of Transposition of Great Arteries With Ventricular Septal Defect and Left Ventricular Outflow Tract Obstruction: Midterm Results World Journal for Pediatric and Congenital Heart Surgery, July 1, 2010; 1(2): 163 - 169. [Abstract] [Full Text] [PDF]

				S. Hu, Y. Xie, S. Li, X. Wang, F. Yan, Y. Li, Z. Hua, and Y. Li Double-Root Translocation for Double-Outlet Right Ventricle With Noncommitted Ventricular Septal Defect or Double-Outlet Right Ventricle With Subpulmonary Ventricular Septal Defect Associated With Pulmonary Stenosis: An Optimized Solution Ann. Thorac. Surg., May 1, 2010; 89(5): 1360 - 1365. [Abstract] [Full Text] [PDF]

				C. S. Park, D.-M. Seo, J.-J. Park, Y. H. Kim, and I.-S. Park The significance of pulmonary annulus size in the surgical management of transposition of the great arteries with ventricular septal defect and pulmonary stenosis J. Thorac. Cardiovasc. Surg., January 1, 2010; 139(1): 135 - 138. [Abstract] [Full Text] [PDF]

				S. M. Emani, R. Beroukhim, D. Zurakowski, F. A. Pigula, J. E. Mayer, P. J. del Nido, T. Geva, and E. A. Bacha Outcomes After Anatomic Repair for D-Transposition of the Great Arteries With Left Ventricular Outflow Tract Obstruction Circulation, September 15, 2009; 120(11_suppl_1): S53 - S58. [Abstract] [Full Text] [PDF]

				M. A. Navabi, R. Shabanian, A. Kiani, and M. Rahimzadeh The effect of ventricular septal defect enlargement on the outcome of Rastelli or Rastelli-type repair J. Thorac. Cardiovasc. Surg., August 1, 2009; 138(2): 390 - 396. [Abstract] [Full Text] [PDF]

				B. Alsoufi, A. Awan, A. Al-Omrani, M. Al-Ahmadi, C. C. Canver, Z. Bulbul, A. Kalloghlian, and Z. Al-Halees The Rastelli Procedure for Transposition of the Great Arteries: Resection of the Infundibular Septum Diminishes Recurrent Left Ventricular Outflow Tract Obstruction Risk Ann. Thorac. Surg., July 1, 2009; 88(1): 137 - 143. [Abstract] [Full Text] [PDF]

				D. Di Carlo, Y. Lecompte, B. Tomasco, L. Cohen, and P. Vouhe Surgery for malposition of the great arteries: the REV procedure MMCTS, January 1, 2009; 2009(0123): mmcts.2007.003046 - mmcts.2007.003046. [Abstract] [Full Text] [PDF]

				A. M. Gaca, J. J. Jaggers, L. T. Dudley, and G. S. Bisset III Repair of Congenital Heart Disease: A Primer-Part 1 Radiology, June 1, 2008; 247(3): 617 - 631. [Abstract] [Full Text] [PDF]

				B. Davies, G. Oppido, J. L. Wilkinson, and C. P. Brizard Aortic translocation, Senning procedure and right ventricular outflow tract augmentation for congenitally corrected transposition, ventricular septal defect and pulmonary stenosis Eur J Cardiothorac Surg, May 1, 2008; 33(5): 934 - 936. [Abstract] [Full Text] [PDF]

				S.-S. Hu, Z.-G. Liu, S.-J. Li, X.-d. Shen, X. Wang, J.-p. Liu, F.-X. Yan, L.-q. Wang, and Y.-q. Li Strategy for biventricular outflow tract reconstruction: Rastelli, REV, or Nikaidoh procedure? J. Thorac. Cardiovasc. Surg., February 1, 2008; 135(2): 331 - 338. [Abstract] [Full Text] [PDF]

				V. O. Morell and P. D. Wearden Nikaidoh operation for transposition of the great arteries with a ventricular septal defect and pulmonary stenosis MMCTS, January 1, 2008; 2008(0220): mmcts.2006.002337 - mmcts.2006.002337. [Abstract] [Full Text] [PDF]

				J. Horer, C. Schreiber, E. Dworak, J. Cleuziou, Z. Prodan, M. Vogt, K. Holper, and R. Lange Long-Term Results After the Rastelli Repair for Transposition of the Great Arteries Ann. Thorac. Surg., June 1, 2007; 83(6): 2169 - 2175. [Abstract] [Full Text] [PDF]

				M. Hazekamp, F. Portela, and M. Bartelings The optimal procedure for the great arteries and left ventricular outflow tract obstruction. An anatomical study Eur J Cardiothorac Surg, May 1, 2007; 31(5): 879 - 887. [Abstract] [Full Text] [PDF]

				T. Yeh Jr, C. Ramaciotti, S. R. Leonard, L. Roy, and H. Nikaidoh The aortic translocation (Nikaidoh) procedure: Midterm results superior to the Rastelli procedure J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 461 - 469. [Abstract] [Full Text] [PDF]

				A. A. Alghamdi, B. W. McCrindle, and G. S. Van Arsdell Physiologic Versus Anatomic Repair of Congenitally Corrected Transposition of the Great Arteries: Meta-Analysis of Individual Patient Data Ann. Thorac. Surg., April 1, 2006; 81(4): 1529 - 1535. [Abstract] [Full Text] [PDF]

				H Sugiyama, W Williams, and L N Benson Implantation of endovascular stents for the obstructive right ventricular outflow tract Heart, August 1, 2005; 91(8): 1058 - 1063. [Abstract] [Full Text] [PDF]

				V. O. Morell, J. P. Jacobs, and J. A. Quintessenza Aortic Translocation in the Management of Transposition of the Great Arteries With Ventricular Septal Defect and Pulmonary Stenosis: Results and Follow-Up Ann. Thorac. Surg., June 1, 2005; 79(6): 2089 - 2093. [Abstract] [Full Text] [PDF]

				I. E. Konstantinov, F. Rosapepe, J. A. Dearani, V. V. Alexi-Meskishvili, and J. Li A Tribute to Giancarlo Rastelli Ann. Thorac. Surg., May 1, 2005; 79(5): 1819 - 1823. [Abstract] [Full Text] [PDF]

				J. R. Lee, H. G. Lim, Y. J. Kim, J. R. Rho, E. J. Bae, C. I. Noh, Y. S. Yun, and C. Ahn Repair of transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction Eur J Cardiothorac Surg, May 1, 2004; 25(5): 735 - 741. [Abstract] [Full Text] [PDF]

				M. Yamagishi, K. Shuntoh, T. Matsushita, K. Fujiwara, T. Shinkawa, T. Miyazaki, and N. Kitamura Half-turned truncal switch operation for complete transposition of the great arteries with ventricular septal defect and pulmonary stenosis J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 966 - 968. [Full Text] [PDF]

				C. Kreutzer Rastelli repair for transposition of the great arteries J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 974 - 974. [Full Text] [PDF]

				A. Murakami, N. Motomura, T. Takaoka, J. Kobayashi, K. Maeda, T. Yamamoto, M. Chikada, T. Ootsuka, Y. Kotsuka, and S. Takamoto Coronary-coronary bypass and pulmonary artery reconstruction related to Wegener granulomatosis in a 22-year-old woman J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 721 - 723. [Full Text] [PDF]

				R. Sharma, S. K. Choudhary, A. Bhan, R. P. Kumar, R. Juneja, S. S. Kothari, A. Saxena, and P. Venugopal Late outcome after arterial switch operation for complete transposition of great arteries with left ventricular outflow tract obstruction Ann. Thorac. Surg., December 1, 2002; 74(6): 1986 - 1991. [Abstract] [Full Text] [PDF]

				Y. Lecompte Rastelli repair for transposition of the great arteries: Still the best choice? J. Thorac. Cardiovasc. Surg., January 1, 2002; 123(1): 192 - 193. [Full Text]

				R. Pretre, G. Gendron, D. Tamisier, F. Vernant, D. Sidi, and P. Vouhe Results of the Lecompte procedure in malposition of the great arteries and pulmonary obstruction Eur J Cardiothorac Surg, March 1, 2001; 19(3): 283 - 289. [Abstract] [Full Text] [PDF]