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Truncus arteriosus repair: A 40-year multicenter perspective.

Phillip S Naimo1, Douglas Bell2, Tyson A Fricke1

  • 1Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.

The Journal of Thoracic and Cardiovascular Surgery
|July 13, 2020
PubMed
Summary

Truncus arteriosus (TA) repair in neonates has challenges, but prompt surgery improves outcomes. Survival past the first year after TA repair is linked to excellent long-term results.

Keywords:
congenital heart diseasesurgerytruncal valvetruncus arteriosus

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiovascular Surgery

Background:

  • Truncus arteriosus (TA) is a rare congenital heart defect requiring surgical intervention.
  • Long-term outcomes following TA repair are crucial for patient management and prognosis.

Purpose of the Study:

  • To evaluate the long-term surgical outcomes and survival rates in patients who underwent truncus arteriosus (TA) repair.
  • To identify risk factors for early and late mortality after TA repair.

Main Methods:

  • Retrospective review of medical records for 255 patients who underwent TA repair between 1979 and 2018 across 3 Australian hospitals.
  • Analysis of data from initial admission through last cardiology follow-up, including survival, reoperation rates, and functional status.

Main Results:

  • Overall survival at 20 years was 76.8%. Neonatal surgery and low weight were risk factors for early mortality.
  • A coronary artery anomaly and early reoperation were risk factors for late mortality.
  • 175 patients required reoperation; freedom from reoperation at 20 years was 2.9%. Survivors showed excellent functional status (NYHA class I/II).

Conclusions:

  • Truncus arteriosus (TA) repair in neonates presents significant surgical challenges, necessitating prompt intervention for those with overcirculation.
  • Survival beyond the first year post-TA repair is associated with excellent long-term outcomes.
  • Coronary artery anomalies are identified as a risk factor for late mortality, highlighting the need for vigilant follow-up.