Rastelli procedure for repair of transposition of the great arteries [S, D, L] complex

Transposition of the great arteries with [S, D, L] segmental anatomy is a rare complex congenital heart lesion. The morphologic features of this unusual disease make surgical repair more challenging than in [S, D, D] transposition. Here reported is the experience with the surgical treatment of this pathologic condition in 2 patients presenting with significant associated anomalies of the right side of the heart and pulmonary outflow tract. Relevance of the specific anatomic features of the transposition [S, D, L] complex is reviewed in terms of feasibility of biventricular repair using the Rastelli operation.