A case report of Rastelli operation in 2-month-old infant with truncus arteriosus (type II)

A two-month-old girl with heart failure from truncus arteriosus (Collett & Edwards Type II) underwent a total correction by the Rastelli procedure using 12-mm-diameter Hancock valved conduit. The orifice of pulmonary arteries was closed from inside without detachment of the pulmonary artery from truncus. The distal anastomosis of the conduit was made to left pulmonary artery. Primary sternal closure was difficult and delayed closure was performed using splint with a resin plate. The skin was primarily closed using bilateral advancement myocutaneous flaps. Complete closure of the sternum was made on the 11th postoperative day. A rotation flap of the right abdominal rectal muscle was used to cover the partially necrotic skin over the sternum. The patient had persistent respiratory and cardiac problems, but was discharged 14 months after surgery.