Excerpt

In this paper, the authors reviewed their series of Yasui operations. This procedure is employed in neonates with interrupted aortic arch and left ventricular outflow tract obstruction (IAA/LVOTO) or aortic atresia-severe stenosis with ventricular septal defect (AA/VSD) and two adequate-sized ventricles. This combines a Norwood arch reconstruction with a Rastelli operation, establishing a biventricular repair. From 2002 to 2011, 21 neonates aged 3–55 days (mean 12.2 days, median 7 days) had IAA/LVOTO (n = 13), AA/VSD (n = 7), or AA/IAA with aortopulmonary window (n = 1); ten (48 %) had genetic abnormalities (8 with DiGeorge syndrome). Based on clinical characteristics and surgeon preference, 6 had a primary Yasui repair (4 AA/VSD, 2 IAA/LVOTO); 15 were staged with an initial Norwood repair (3 AA/VSD, 12 IAA) followed by Yasui completion in 13 (2 await completion) 4.3–26.6 months later (median 6.9 months). Early mortality was zero with no interstage deaths in the staged patients. One patient died 2 months after staged repair. Since biventricular repair, 8 survivors (44 %) had reoperation for conduit replacement (n = 6), recurrent LVOTO (n = 1), or a residual VSD (n = 1). No patient requires a pacemaker. There were three late deaths after biventricular repair, all in patients with genetic syndromes and IAA/LVOTO. Actuarial survival after initial operation was 100 % at 1 year and 75 % at 5 years. Actuarial freedom from reoperation or death after biventricular repair was 14 % at 5 years. …