The Rastelli repair

Update: Albie didn’t get his Rastelli the next week as was planned when this was written. We went home again to make him bigger and he ended up having his operation on 14 August 2012. But its still a good description of the operation itself, so I have left it here.

We’ve been rabbiting on about his ‘Rastelli’ and done nothing to explain exactly what will happen next week. For those of you who have wanted to know, here we go.

The Rastelli is open-heart surgery. That means that the operation will require Albie to be placed on a heart-lung bypass machine.   The bypass machine takes over the function of the heart and lungs to provide oxygenated blood to the body. Albie will also be cooled right down so he is hypothermic (body temperature is usually kept at 28ºC to 32ºC) throughout the repair. This slows the body’s metabolic rate, decreasing its demand for oxygen. Once he is on bypass, his heart will then be stopped so that it can be opened and repaired in a bloodless, still environment.

They will cut through his breast bone (sternum) to access his heart. At the end of the operation, the two edges of the breast bone are put back together with steel wires. After the chest is opened, to get access to the heart, the pericardial sac has to be opened too. This is the leather-like protective pouch the heart sits in. Who knew?

In the Rastelli repair, the heart will be fixed so that blood will be channelled through the ventricular septal defect that he has from the left ventricle to the aorta. A patch will be put in the right ventricle to prevent blood passing from the right ventricle to the aorta. A conduit (which is an artificial tube containing a graft valve from a human, cow or pig) will be sewn in to connect the right ventricle to the pulmonary artery.

Then the BT shunt he had installed in April will be taken out and all will be well with our wee boy. The operation will take up to 8 hours. I already know it will be the longest 8 hours of my life.

So that’s the low down on next week. There are of course a great string of complications that could happen, but just describing to you all what will happen is enough. We are scared, of course. But thankful too that we live in a country that can do this. The repair has to happen and the only thing to do is just trust.


  1. Albie and Sarah and Marcus,

    All three of you are in our prayers, and your right Sarah, all you can do is trust. May God bless you all through this scary time. love June

  2. Good luck wee one, good luck mom & dad. When my son had his repair, it helped me to break down the time similar to how you’ve broken down the surgery. By 8 am he should be on by-pass, but 9am they should be starting the repair, by 10 am…..and so on. I didn’t think too much about what they were actually, physically doing to his little body, I would have been a mess, or messier, but I did watch the clock and think about where they should be at to help me through. We also got updates from the operating room, and that helped. I hope (if you want to know) that you’ll be able to get updates too. By this time next week, you’ll have a repaired little ticker and a little man ready to get on with the business of being a little boy. Recovery is no picnic, but at least you’ll have the big scary behind you.
    Again, best of luck. I’ll be keeping you all in my thoughts.

  3. I went walking around Melbourne because I couldn’t sit still I was so anxious so I paced. We got lost circling the hospital and that took my mind a little off what was happening to my boy. I knew I was not too far away to return quickly if we were called back early and I did not want that to happen because it meant there would be a problem and I didn’t want to go there. We were still back way to early and sat waiting for the call.
    My baby is now 22 years old and has a full repair. He had a modified blalock shunt at 2 days and 2 right side overhauls one when he was 11 months and 3 years old.
    Can I post your blog to HeartKids Aust facebook page? Many people will be there to support you. Thinking of you as you wait this awful wait.

    • Thanks Punya for your comment – and so lovely to hear about your heart ‘baby’ now 22 years old. We are thinking of going for walks around the hospital too. Its hard to know what else to do during the operation! Its far too long to just sit and wait but its impossible to actually go do anything else too. You are more than welcome to post my blog to the HeartKids Australia group. I have read other CHD blogs avidly and know how useful it is to share experiences and support each other. Much love, Sarah

  4. Sounds like a big repair for such a little boy. good luck little man! and we wish you all a wonderful holiday.
    Lot’s o love John, Sara and Elinor.

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