[Reoperation with a bifurcated nonvalved extracardiac conduit for stenosis of the valved conduit and the pulmonary bifurcation after a Ross-Rastelli operation].

We report a case of successful reoperation with a bifurcated nonvalved extracardiac conduit for stenosis of the valved conduit and the pulmonary bifurcation after a Ross-Rastelli operation. The patient was 11-year-old female, who had undergone Ross-Rastelli operation with a 16 mm Carpentier-Edwards valved conduit for pulmonary atresia with ventricular septal defect at six year-old following Blalock-Taussig shunt at four year-old. She required reoperation for progressive right heart failure due to stenosis of the valved conduit and the pulmonary bifurcation. The reoperation was performed under cardiopulmonary bypass with aortic crossclamp. The stenosed valved conduit placed between the right ventricle and the right pulmonary artery was removed and replaced with 18 mm EPTFE graft. Because the direct repair of the pulmonary bifurcation stenosis was thought to be difficult, a 12 mm ringed EPTFE graft was anastomosed to the left pulmonary artery distal to the bifurcation stenosis as a branch of the 18 mm EPTFE main graft. Although transitional heart failure required IABP support in her early postoperative course, she subsequently recovered and discharged the hospital at the 37th postoperative day. Her right ventricular pressure reduced from 105 mmHg to 54 mmHg by the cardiac catheterization. She is now alive and well without any complaints.