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

Kreutzer, Christián; Vive, Julie De; Oppido, Guido; Kreutzer, Jacqueline; Gauvreau, Kimberlee; Freed, Michael D.; Mayer, John E.; Jonas, Richard A.; Nido, Pedro J. del

doi:10.1067/mtc.2000.108163

Cited by 205 publications

(149 citation statements)

References 30 publications

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“…6,7 These findings have prompted increased utilization of aortic translocation for patients with TGA/LVOTO, and this study confirms a lower incidence of LVOT reintervention in aortic translocation compared to Rastelli. 8,9 The low incidence of LVOT reintervention after aortic translocation is likely attributable to the positioning of the aortic valve over the true anatomic LV outflow, resulting in subaortic outflow unencumbered by conus or septal muscle.…”

Section: Discussionsupporting

confidence: 69%

Outcomes After Anatomic Repair for D-Transposition of the Great Arteries With Left Ventricular Outflow Tract Obstruction

et al. 2009

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Background-D-transposition of the great arteries (TGA) with left ventricular outflow tract obstruction (LVOTO) may be treated with arterial switch operation (ASO) with or without LVOT intervention, as well as non-ASO anatomic repairs, such as aortic translocation or Rastelli procedure. We evaluated midterm results of repair for TGA/LVOTO at our institution. Methods and Results-Eighty-eight patients with TGA/LVOTO who underwent anatomic repair were retrospectively reviewed. LVOTO was defined as pulmonary valve (PV) z-score ՅϪ2.0 or LVOT gradient Ն20 mm Hg in the presence of anatomic subvalvar stenosis. Risk factors for LVOT reintervention were determined by logistic regression. There was no hospital mortality and 1 late mortality. Patients undergoing Rastelli procedure were more likely to require surgical reintervention for LVOTO compared to the other groups (Pϭ0.015). Patients undergoing ASO alone had a higher rate of late LVOT reintervention compared to those who had concomitant ASO/LVOT intervention (PϭNS). In those undergoing Rastelli, a larger PV z-score was a predictor of LVOT reintervention (Pϭ0.012). PV z-scores significantly decreased before repair in patients undergoing delayed repair (Pϭ0.005); however, they increased significantly after neonatal ASO (PϽ0.001). Conclusions-Patients

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Section: Discussionsupporting

confidence: 69%

Outcomes After Anatomic Repair for D-Transposition of the Great Arteries With Left Ventricular Outflow Tract Obstruction

et al. 2009

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“…In 2000, Kreuzer et al published a paper summarizing their 25-year long surgical experience with the Rastelli procedure (1973-1998, 101 patients). After 20 years, 52% of the patients survived and did not require a heart transplant [12]. This percentage was greatly improved thanks to the further advancement of operative technique, better myocardial protection, changes in surgery qualification criteria, and broader experience of cardiac surgeons.…”

Section: The Rastelli Proceduresmentioning

confidence: 92%

History of cardiac and thoracic surgery A cardiac surgeon, his way to holiness, and his heritage – the 80 th anniversary of Giancarlo Rastelli’s birthday and the 45 th anniversary of the first Rastelli procedure

Mazurak¹,

Kusa²

2013

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StreszczenieGiancarlo Rastelli urodził się 80 lat temu w miejscowości Pescara we Włoszech. Jego nazwisko zostało unieśmiertelnio-ne w postaci eponimów określających klasyfikację ubytku przegrody przedsionkowo-komorowej (klasyfikacja Rastelliego) oraz technikę zabiegu operacyjnego stosowanego m.in. w przełożeniu wielkich pni tętniczych z ubytkiem przegrody międzykomorowej i zwężeniem drogi odpływu lewej komory (operacja metodą Rastelliego). Giancarlo Rastelli zmarł w 1970 r. w wieku 36 lat. Od 2005 r. w Watykanie trwa jego proces beatyfikacyjny. W opracowaniu przedstawiono aktualne spojrzenie na klasyfikację Rastelliego, jak również problemy związane z operacją metodą Rastelliego oraz alternatywne metody leczenia stosowane w poszczególnych przypadkach, tj. metodę Nikaidoh, REV i Metras. Słowa kluczowe: operacja Rastelliego, klasyfikacja Rastelliego, historia medycyny. Kardiochirurgia i Torakochirurgia Polska 2013; 10 (4) 441 HISTORY OF CARDIAC AND THORACIC SURGERY AbstractCardiac surgeon Giancarlo Rastelli was born 80 years ago in Pescara, Italy. His name was immortalized in such eponyms as the Rastelli classification (classification of atrioventricular septal defects) and the Rastelli procedure (among other applications, used for the treatment of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction). Giancarlo Rastelli died in 1970 at the age of 36. His beatification has been in progress at the Vatican since 2005. This paper presents the current view on the Rastelli classification, the problems related to the Rastelli procedure, as well as alternative procedures applied in specific cases, i.e. the Nikaidoh, REV, and Metras procedures.

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“…13 There are few previous reports on pregnancy in patients who have undergone the Rastelli operation 14 and there is no published information to date about pregnancy in DOLV patients.…”

Section: Discussionmentioning

confidence: 99%

Successful Pregnancy in a Patient With Double Outlet Left Ventricle After a Rastelli Operation Using a Prosthetic Valve

Fukuda

Oku

Nakamoto

et al. 2004

Circ J

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ouble outlet left ventricle (DOLV) is a rare (incidence of fewer than 1 in 200,000 1 ) congenital cardiac malformation in which the aorta and the pulmonary trunk both arise entirely or predominantly above the morphological left ventricle. Increasing numbers of children with congenital heart disease (CHD) are surviving to reproductive age, and successful pregnancies in patients who have undergone surgery for CHD are being reported with increasing frequency. 2-6 However, there have been no reports to date on pregnant patients who have undergone a radical operation using a prosthetic valve for DOLV.Pregnant women with a prosthetic valve replacement present significant problems in management, primarily because of the high incidence of embolization 7 and therefore they require prophylaxis against thromboembolism.We report here on a successful planned delivery in a patient with DOLV who had undergone a Rastelli operation using a prosthetic valve. Case ReportA pregnant 35-year-old woman (gravida 4, para 1, aborta 3) who had been diagnosed with DOLV was referred at 4 weeks' gestation. At age 11, she had undergone a Rastelli operation in which the pulmonary valve was replaced with a 21 mm Björk-Shiley prosthesis. After surgery, anticoagulant therapy with warfarin was initiated, and her heart condition improved from New York Heart Association (NYHA) functional class III to class I. Postoperative cardiac catheterization and angiographic study were performed at 2Circulation Journal Vol.68, May 2004 (Table 1) and 7 years (Table 2) after operation and the patient's right ventricular pressure was 56/0 mmHg and 46/0 mmHg, respectively. There was no residual ventricular septal defect shunt.The patient married at age 24 years and became pregnant at 26, but the fetus died at 8 weeks gestation and the patient subsequently underwent an evacuation without complications. Her second pregnancy occurred at the age of 28 years. At 32 weeks' gestation, the prosthetic click disappeared and at this point, the patient's warfarin intake was 3 mg daily. The diagnosis of prosthetic obstruction because of probable valve thrombosis was made, and intravenous heparin therapy was initiated. The prosthetic click remained inaudible, but there was no change in the patient 's Circ J 2004; 68: 501 -503 (Received May 10, 2002; revised manuscript received September 11, 2002; accepted September 18, 2002

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

Abstract: 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.

Cited by 205 publications

References 30 publications

Outcomes After Anatomic Repair for D-Transposition of the Great Arteries With Left Ventricular Outflow Tract Obstruction

Outcomes After Anatomic Repair for D-Transposition of the Great Arteries With Left Ventricular Outflow Tract Obstruction

History of cardiac and thoracic surgery A cardiac surgeon, his way to holiness, and his heritage – the 80 th anniversary of Giancarlo Rastelli’s birthday and the 45 th anniversary of the first Rastelli procedure

Successful Pregnancy in a Patient With Double Outlet Left Ventricle After a Rastelli Operation Using a Prosthetic Valve

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