REV Procedure
Also known as: réparation à l'étage ventriculaire, surgery for malposition of the great arteries
What is the REV procedure?
Réparation à l'étage ventriculaire, more commonly known as the REV procedure, is a surgical operation used to repair certain complex congenital heart defects, most commonly transposition of the great arteries (TGA) or double outlet right ventricle (DORV) associated with a ventricular septal defect (VSD) and pulmonary stenosis. The REV procedure has been in use since the 1980s and was developed to overcome some of the limitations of earlier surgical approaches used to treat these conditions.
The goal of the REV procedure is to restore a more normal circulation, allowing blood to flow efficiently from the heart to the lungs and the rest of the body. By correcting the underlying anatomical problem, the procedure aims to improve oxygen levels, exercise capacity, growth, and long-term quality of life.
What happens during the procedure?
The REV procedure is a major open-heart operation performed under general anesthesia and with the support of a cardiopulmonary bypass machine. During surgery, an intracardiac repair is performed to redirect blood flow from the left ventricle to the aorta through the ventricular septal defect (VSD). The surgeon then reconstructs the right ventricular outflow tract to establish an unobstructed pathway for blood to flow from the right ventricle to the lungs.
Once the procedure is completed, the patient is gradually weaned from the cardiopulmonary bypass machine. Most children will spend several days in the cardiac intensive care unit before moving to a regular ward. The total hospital stay is typically between two and four weeks, although recovery times may vary from one child to another.
Is any special preparation needed?
Before surgery, your child will undergo a series of diagnostic tests to determine whether the REV procedure is the most appropriate treatment option. These investigations may include echocardiography, cardiac catheterization, CT or MRI imaging, and other assessments as recommended by your medical team.
Your doctors will provide detailed instructions regarding medications, feeding, and other preparations before the operation. For example, your child may need to avoid food and certain medications for a period of time before surgery.
What are the risks?
The REV procedure is a complex open-heart operation and, like all major cardiac surgeries, carries potential risks. Your child's medical team will discuss these risks with you in detail and explain the expected benefits of the procedure in your child's specific situation.
Although complications can occur, advances in surgical techniques, anesthesia, intensive care, and postoperative management have significantly improved outcomes over the past several decades. In experienced congenital heart centers, the REV procedure is considered an effective and well-established treatment for appropriately selected patients.
What can families expect after surgery?
Most children experience a significant improvement in oxygen levels, exercise tolerance, growth, and overall wellbeing after successful surgery. Regular follow-up with a congenital heart disease specialist is important throughout childhood and adulthood to monitor heart function and ensure the best possible long-term outcome.
Although some patients may require additional interventions later in life, advances in surgical techniques, intensive care, and long-term follow-up have led to excellent outcomes for most children undergoing the REV procedure. Many patients grow up to attend school, play with friends, participate in sports, pursue careers, and enjoy family life just like their peers.
Reviewed by: David Kalfa, MD
This page was last updated on: June 25, 2026 03:54 PM