Explain Le Compte Operation-REV Procedure ?

This is an alternative type of repair for TGA, VSD and left ventricular outflow obstruction (LVOTQ). In this operation an extrinsic conduit is not used.

Initial steps of the operation are the same as for n Rastelli repair. After establishing CP bypass and aorta is cross clamped, cold cardioplegic arrest is achieved. Left side of the heart is vented. Intra ventricular tunnel repair of VSD is done to divert 1eft ventricular flow to the aorta. The pulmonary trunk is divided distal to the valve and proximal part sutured. The well-mobilized pulmonary artery is brought anterior to the aorta (le Compte maneuvre as in a switch operation). The transacted aorta is then reconstructed post&or and to the left of the pulmonary artery. The posterior part of the pulm6nq artery is sutured to the upper end of right ventriculotomy. Using a pericardial patch, reconstruction of the right ventriculotomny and that of anterior part of pulmonary artery is done. The disadvantage of the operation is that there is no valve in the pulmonary outflow. However, it has the advantage of growth of pulmonary artery as no synthetic conduit is used.