Between Jan. 1986 and Aug. 1992. 72 patients underwent Rastelli procedure. There were 43 male and 29 female, aged 46 days to 16 years(mean age 5.2 years) with 18 patients less than 2 years of age.
All patients had complex defect, 27 pulmonary atresia with ventricular septal defect, 18 corrected transposition of great arteries wit pulmonary atresia or pulmonary stenosis, 10 truncus arteriosus, 10 double outlet right ventricle with pulmonary
atresia or stenosis, 7 completed transposition of great atresia with pulmonary atresia or pulmonary stenosis.
The types of extracardiac valved conduit used were prosthetic valve(n=47, 24 carbomedics, 19 Ionescu-shiley) and hand-made trileaflet valve using pericardium. (n=23, 20 bovine pericardium, 2 autologous pericardium, 1 equine pericardium) The mean
size of
valved cinduit was 5.25mm larger in diameter than the size of main pulmonary artery. (normalized to the patient's body surface area)
There were 17 hospital death 24%) and 4 late deaths(5.6%). Postoperative complication rate was 38.9%, none of which was conduit-related. All patients were followed postoperatively for 1 to 73 months. (mean 25.8 months) During follow-up period,
reoperation was done in 6 patients due to stenosis of valved conduit. Mean interval between intial repair and reoperation was 20.3 months.
In our experience, 1) recently extracardaic valved conduits between right ventricle (or pulmonary ventricle) and pulmonary artery were inserted with increasing frequency in infants less than 2 year, but hospital mortality was decreases, 2) Risk
of
reoperation due to conduit stenosis is low, so that the effect of graft failure on overall survival is minimized. 3) Nevertheless, because any type of extracardaic valved conduit is not ideal in children, we recommentded that Lecompte should be
done if
cardiac anatomy is permitted.
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