Repair of truncus arteriosus: choice of right ventricle outflow reconstruction

To find a better method of right ventricular-pulmonary artery (RV-PA) reconstruction in repairing truncus arteriosus (TA). BASIC STUDIES DESIGN: Retrospective clinical study, contrast study.

Shanghai Children's Medical Center.

23 patients with truncus arteriosus.

To decrease the man-made interference, all of the exams during the follow-up period were carried out at our center.

Hospital death, survival rate, the later outcomes during follow-up including the growth of pulmonary artery, the later heart function, and reintervention.

There were two early hospital deaths, with no deaths during follow-up. The overall survival rate was 91.30%. One patient underwent reintervention for RVOTO. In Group 1, the difference between the diameters of RV-PA anastomosis was statistically significant. The early diameter was 1.01 ± 0.26 cm, the later was 1.32 ± 0.45 cm, p = 0.019. The velocity of flow at the position of anastomosis and the orifice of RPA/LPA was acceptable. There was a significant difference between the growth ratio of the RV-PA anastomosis of two groups, with a p value of 0.048. The later ejection fraction was higher than the early one in both groups. There was no reintervention for truncal valve regurgitation.

The postoperative survival and follow-up results were satisfactory. A direct anastomosis of RV-PA continuity has the potential for RVOT growth and is associated with a low ratio of pulmonary artery and bifurcation obstruction. The myocardial function improved during follow-up period. IAA was a major risk factor associated with hospital death.