COMBINED NORWOOD AND RASTELLI PROCEDURE FOR REPAIR OF INTERRUPTED AORTIC-ARCH WITH SUBAORTIC STENOSIS

A neonate presented with an interrupted aortic arch type B and VSD wit h dysplastic aortic valve, subaortic stenosis, and aberrant right subc lavian artery. We performed a direct anastomosis between the hypoplast ic ascending aorta (empty set 3 mm), the main pulmonary artery and the descending aorta, mimicking a Norwood-type ventricular outlet. The ri ght-ventricular outflow tract was reconstructed with a 8 mm PTFE vascu lar graft. This combination of a modified Norwood with a Rastelli proc edure facilitated establishment of a sufficiently large left-ventricul ar outflow tract via VSD, at the same time maintaining a biventricular system despite the coexisting anomalies.