All issues > Volume 46(3); 2003

Original Article

J Korean Pediatr Soc. 2003;46(3):259-264. Published online March 15, 2003.

Postoperative Progress and Influencing Factors in Patients after Rastelli Procedure

Se Heui SH Kim¹, Kyeong Sik KS Kim¹, Jong Kyun JK Lee¹, Jae Young JY Choi¹, Jun Hee JH Sul¹, Sung Kyu SK Lee¹, Young Whan YW Park², Bum Koo BK Cho²

¹Division of Pediatric Cardiology, Yonsei Cardiovascular Center, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea

Correspondence Jae Young JY Choi ,Email: cjy0122@yumc.yonsei.ac.kr

Abstract

Purpose
: We have performed an analysis on patients who received Rastelli operation in our institute and reviewed their progress postoperatively. Various factors with suspected relationship to the outcome have been considered to help in future treatment and follow-up.
Methods
: We analyzed retrospectively 43 patients who either received Rastelli operation in Yonsei University Cardiovascular Center from March 1995 to April 1997 or who received post-procedural cardiac catheterization and follow-up echocardiography in the out-patient department after the procedure.
Results
: No statistically valid relationships were found between the age of the patient, their body weight, preoperative pulmonary arterial index and pressure, presence of pulmonary branchial stenosis and postoperative results. Cases with atrioventricular concordance showed lower age and body weight, and discordant cases exhibited lower ejection fraction 3 days postoperatively. Upon follow up, lower NYHA score was seen in patients with severe residual stenosis. In the group that received cardiac catheterization after the procedure, residual stenosis and right ventricular pressure measurement in echocardiography showed good correlation with the catheterization data.
Conclusion
: In cases where conduit insertions of the right ventricular outflow tract are required to achieve total correction in complex cardiac deformity, early operation does not seem to provide a clear risk to the patient. In patients with atrioventricular discordance, careful postoperative observation of the ventricular function seems to be needed. Also, echocardiography appears to be a sound method in follow-up of patients after the correctional procedure.

Keywords :Rastelli procedure, Hemodynamcis, Atrioventricular discordance, Cardiac catheterization, Echocardiography