Surgical considerations of ventricular septal defect associated with complete transposition of the great arteries and pulmonary stenosis, with special reference to the Rastelli operation

Ventricular septal defect (VSD) associated with complete transposition of the great arteries was studied, and each of the typical anatomic varieties was depicted to emphasize the characteristic features of the VSD. Among the 32 specimens, 13 cases were found to have a VSD lying anterosuperior to the origin of the papillary muscle of the conus, indicating that repair of the VSD could be performed without difficulty. Such a defect situated above the crista supraventricularis has proved to be technically most preferable, as shown in the case report. In contrast, the remaining 19 cases appeared to be inappropriate for the technique, as the VSD was overhung by a part of the tricuspid valve. Additional analysis was made of the angiocardiographic appearances of the VSD, demonstrating some characteristic patterns.