RVOT

Hi,

my daughter has tetralogy of fallots which was correct in 1998 when she was 7 mths.  She is now waiting for a date to have another operation.  She has to have a resection of her RVOT obstruction and right ventricle to pulmonary artery conduit.  Could you tell me if this means she will have the "Rastelli" procedure.

Many thanks

Sandra

[Marie M Gleason, M.D.]

A "Rastelli" operation is a specific set of procedures done at one open heart surgery:  a patch is placed to close a ventricular septal defect (VSD) and channel the blood from the left ventricle to the aorta (wherever that is located) and a conduit (tube graft) is placed between the right ventricle and the pulmonary artery branches.  Sometimes a Rastelli is done at the initial repair of tetralogy of fallot, but only under certain circumstances.  If your daughter is having a reoperation for a recurrent muscle bundle in the right ventricle (RVOT obstruction) and a revision of a true conduit, then she likely had a Rastelli at 7 months of age.  This reoperation would not be considered a Rastelli, because the VSD is already closed.  It is common for this to happen once children outgrow the conduit that was put in when they were very young.