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These results represent a considerable improvement over those of the Rastelli operation in terms of survival and need for reoperation for right or left ventricular outflow tract obstruction.

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SummaryFrom November 1982 to July 1989, fifty patients were treated by the REV procedure for complete transposition associated with ventricular septal defect and obstruction of the pulmonary outflow tract. The age at operation ranged from 4 months to 15 years (mean 3.8 years). The technique, based on the resection of the outlet (infundibular) septum, is described in detail. Operative mortality was 18%, essentially related to technical errors or faulty indications at the beginning of our experience. There was no late death. Six patients needed reoperation for pulmonary stenosis (2 cases) or a residual defect, in some cases associated with tricuspid regurgitation. All survivors were in excellent clinical condition. The REV procedure has fewer limitations and better results than the classical approach using Rastelli's procedure.