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.
valved conduits; valved conduits; Rastelli operation