A 13-year-old boy, who had undergone a Rastelli procedure 8 years before, developed
severe extracardiac conduit stenosis and infectious endocarditis. Sternal re-entry
appeared to be dangerous and to require extensive adhesiolysis. 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.
Extracardiac conduit - Left anterior small thoracotomy - Infectious endocarditis -
Broadly based autologous pericardium
