Abstract
The Rastelli (RAST) procedure has become the gold standard for repairing lesions with ventriculo-arterial discordance and sub-pulmonary stenosis. However, the RAST procedure is associated with a high frequency of conduit obstruction, which led to the development of Réparation à l'étage ventriculaire (REV). Despite reports of reduced re-operations for right ventricular outflow tract obstruction, the REV procedure is not commonly used due to concerns about its potentially higher operative mortality compared to the RAST procedure. This study aimed to determine whether the operative mortality was indeed higher with the REV procedure. A systematic search of Google Scholar and PUBMED was conducted, covering studies published between January 1st, 1966, and March 15th, 2025. Papers reporting on both RAST and REV procedures were selected to minimize patient and method heterogeneity, and a meta-analysis was performed to compare operative mortality. Four studies representing 347 patients were included: 80 underwent the REV procedure, and 267 underwent the RAST procedure. The operative mortalities were 13.8% for REV and 4.9% for RAST, with an odds ratio of 2.42 [0.93; 6.31] and a p-value of 0.759. The analysis showed that the operative mortality of the REV procedure was not significantly different from that of the RAST procedure.
Key words: Rastelli, réparation à l'étage ventriculaire (REV), transposition, great, arteries.
