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ISSN (On-line): 1678-9741 Impact Factor: 0.809
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Volume 3 Number 2, May - August, 1988

ORIGINAL ARTICLE

DOI: http://dx.doi.org/10.1590/S0102-76381988000200002

Rastelli operation with bovine pericardium valved conduit: early experience

Operação de Rastelli utilizando-se conduto valvulado de pericárdio bovino: experiência inicial

Carlos R Moraes; Jorge V Rodrigues; Cláudio A Gomes; Lorella Marinucci; Cleuza Lapa Santos; Tereza Cristina Coelho; Ivan de Lima Cavalcanti

Correspondence To:
Carlos R. Moraes
Av. Bernardo Vieira de Melo, 4405/491 Jaboatão
56.100 Recife, PE, Brasil

ABSTRACT
The present report describes the initial experience with the Rastelli operation utilizing a composite graft of glutaraldehyde preserved bovine pericardium. The graft is made up of a tube which serves to reconstruct the outflow tract of the right ventricle and the pulmonary artery, and an inner tricuspid valve, without a supporting ring, which provides the tube with a one-way flow mechanism. From May, 1986 to October, 1987, five children were submitted to Rastelli operation utilizing this valved tube. Three were female and two male, ranging in age from 1 e to 8 years (mean 5 years). Three had transposition of the great arteries, VSD and subpulmonic stenosis, one had pulmonary atresia, VSD and a previous Waterston shunt, and one had a type II truncus arteriosus. Two patients died of causes unrelated to the type of the conduit used. The valved conduit of preserved bovine pericardium is easy to handle due to its excellent flexibility, allowing perfect adaptability inside the pericardial sac. The absence of a supporting ring abolish gradient across the conduit and turbulence which are recognized causes of calcification.

Keywords valved conduits, bovine pericardium, surgery. Rastelli operation.


RESUMO
O presente trabalho descreve a experiência inicial com a operação de Rastelli, utilizando-se um conduto valvulado de pericárdio bovino preservado em glutaraldeído. O enxerto consta de um conduto, que serve para reconstruir a via de saída do ventrículo direito e o tronco pulmonar, com uma válvula tricúspide suturada em seu interior sem anel de suporte, permitindo, assim, um mecanismo de fluxo unidirecional. De maio de 1986 a outubro de 1987, 5 crianças foram submetidas à operação de Rastelli empregando-se este tipo de conduto valvulado. Três eram do sexo feminino e 2, do masculino, variando a idade de 1 a 8 anos x 5). Três pacientes tinham transposição das grandes artérias, comunicação interventricular (CIV) e estenose subpulmonar. Uma criança era portadora de atresia pulmonar com CIV e de um shunt prévio tipo Waterston e, finalmente, a outra tinha um tronco arterial comum tipo II. Dois doentes faleceram de causas não relacionadas ao tipo de conduto valvulado utilizado. O conduto valvulado de pericárdio bovino preservado em glutaraldeído mostrou excelente flexibilidade, facilitando o manuseio cirúrgico e permitindo perfeita adaptabilidade dentro do saco pericárdico. A ausência de anel de suporte tem a vantagem de eliminar qualquer gradiente e de abolir o turbilhonamento do sangue - causas reconhecidas de calcificação.

Palavras-Chave condutos valvulados, pericárdio bovino, cirurgia. Rastelli, operação de.

Full text available only in portuguese PDF format.

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