Combined mustard and rastelli operations: An alternative approach for repair of associated anomalies in congenitally corrected transposition in situs inversus {I,D,D}

R. M. Di Donato, C. J. Troconis, B. Marino, A. Carotti, F. S. Iorio, E. Rossi, C. Marcelletti

Research output: Contribution to journalArticlepeer-review

Abstract

We report on two patients with congenitally corrected transposition of the great arteries in situs inversus who underwent successful anatomic repair of associated cardiac anomalies-ventricular septal defect and pulmonary outflow tract obstruction. Surgical intervention was influenced by the recently introduced technique of Ilbawi and colleagues in cases of congenitally corrected transposition in situs solitus. Principles of the correction are as follows: (1) patch redirection of venous flows at the atrial level through an incision in the left-sided right atrium; (2) patch closure of the ventricular septal defect through a right ventriculotomy, baffling the left ventricle to the aorta; and (3) valved conduit interposition between the right ventricle and the pulmonary artery. If the ventricular septal defect is restrictive, it can be safely enlarged by extensive resection of the anterosuperior border, because of the postero-inferior location of the bundle of His in this anomaly. With this technique, the left ventricle and the native mitral and aortic valves are recruited for systemic work, with intrinsic long-term advantages. It is, however, a complex procedure involving substantial use of prosthetic material. More experience is necessary to establish whether this approach is superior to currently available physiologic repairs.

Original languageEnglish
Pages (from-to)1246-1248
Number of pages3
JournalJournal of Thoracic and Cardiovascular Surgery
Volume104
Issue number5
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Fingerprint

Dive into the research topics of 'Combined mustard and rastelli operations: An alternative approach for repair of associated anomalies in congenitally corrected transposition in situs inversus {I,D,D}'. Together they form a unique fingerprint.

Cite this