Rastelli procedure
The Rastelli procedure is an open heart surgical procedure developed by Italian physician and cardiac surgery researcher, Giancarlo Rastelli and involves using a pulmonary of aortic homograft conduit to relieve pulmonary obstruction in double outlet right ventricle with pulmonary stenosis (Taussig-Bing heart).
It is used to correct certain combinations of congenital heart defects (CHDs):
- dextro-Transposition of the great arteries (d-TGA), or overriding aorta, or double outlet right ventricle (DORV); and
- Ventricular septal defect (VSD); and
- Right ventricular outflow tract obstruction (RVOTO):
- pulmonary atresia; or
- pulmonary stenosis; or
- subpulmonary stenosis.
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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