K. Imanaka et al., Extracardiac conduit replacement with autologous tissue only, via a left anterior small thoracotomy, THOR CARD S, 47(4), 1999, pp. 251-252
A 13-year-old boy, who had undergone a Rastelli procedure 8 years before, d
eveloped severe extracardiac conduit stenosis and infectious endocarditis.
Sternal re-entry appeared to be dangerous and to require extensive adhesiol
ysis. Through a left anterior small thoracotomy, however, good exposure was
obtained and the operation was performed safely and much less invasively.
The main pulmonary artery was reconstructed with autologous tissues only, i
.e. fibrous tissue bed and broadly based pericardial pedicle. There was no
residual stenosis. The patient convalesced rapidly.