Transposition with ventricular septal defect and pulmonary stenosis: the Rastelli operation

A total of 52 Rastelli operations have been performed at the Mayo Clinic for transposition of the great arteries with ventricular septal defect and pulmonary stenosis. Of the 43 patients over four years of age, two died (5%). A much higher mortality among younger children, in our earlier experience, led to a policy of early palliation, if required, by a Blalock-Taussig shunt, with later correction. The technique which evolved is described. The results of the operation thus far suggest that its success is comparable to that for the repair of the tetralogy.