[Reoperation for obstructed extracardiac valved conduit after Rastelli operation]

Between July 1988 and November 2000, 61 patients who were 11.3 +/- 3.8 years old underwent reoperation for obstructed extracardiac valved conduit at 7.0 +/- 2.1 years after Rastelli operation. The right ventricular outflow tract was reconstructed with nonvalved (n = 36) or valved (n = 9) conduit and Danielson's procedure (n = 16). One patient who underwent Danielson's procedure and concomitant aortic valve replacement died in 7 days after reoperation. Mean systolic pressure gradient across the right ventricular-pulmonary artery decreased from 58.6 mmHg to 14.6 mmHg. Re-reoperation was performed in 6 patients after Danielson's procedure for restenosis caused by contracture of xenograft outflow patches. There is no re-reoperation in patients with nonvalved conduit replacement. Postoperative pulmonary regurgitation by UCG was moderate in 12 patients with nonvalved conduit replacement and two with Danielson's procedure. In our experience, reoperation for obstructed extracardiac valved conduit after Rastelli operation is safe and nonvalved conduit replacement provides good midterm results.