Dextro-transposition of the great arteries rastelli operation

• Done for patients with TGA, VSD, and pulmonary outflow tract obstruction.
• It depends on appropriate VSD anatomy (large and subaortic) because then it will be used as part of the left ventricular outflow tract (LVOT), involving placement of a baffle within the RV to direct blood flow from the VSD to the aorta. A conduit is inserted between the RV and the pulmonary artery, which is stitched.
• Advantage- Left Ventricle becomes the systemic ventricle
• Disadvantage- The conduit will likely need to be replaced several times during the patient's life.
• The appropriate age for this operation is still debated, due to the higher risk with the early repair.
• The younger the patient the smaller the conduit, needing earlier reoperation.