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Surgery for Truncus Arteriosus: Contemporary Practice.

Phillip S Naimo1, Igor E Konstantinov2

  • 1Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia; Heart Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

The Annals of Thoracic Surgery
|August 24, 2020
PubMed
Summary
This summary is machine-generated.

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Surgical repair of truncus arteriosus offers a 75% survival rate at 20 years, with most repairs performed neonatally. Truncal valve competency is key to successful outcomes in this complex congenital heart defect.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Cardiovascular Medicine

Background:

  • Truncus arteriosus repair has historically carried significant early mortality (3-20%).
  • Modern surgical approaches predominantly involve neonatal repair, often addressing concurrent anomalies.
  • Specific patient subgroups, such as those with truncal valve insufficiency or interrupted aortic arch, present unique challenges.

Purpose of the Study:

  • To review the current outcomes and long-term prognosis following surgical repair of truncus arteriosus.
  • To identify critical factors influencing patient survival and quality of life post-repair.
  • To discuss the implications of reoperation and the evolving nature of surgical techniques.

Main Methods:

  • Review of existing literature and clinical data on truncus arteriosus repair outcomes.

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  • Analysis of factors affecting early and long-term survival.
  • Evaluation of the impact of specific anatomical variations and surgical techniques on patient results.

    • Main Results:

    • Long-term survival after truncus arteriosus repair is approximately 75% at 20 years.
    • Truncal valve competency is the most critical determinant of successful surgical outcomes.
    • While conduits necessitate future reoperations, many patients achieve good long-term quality of life.

    Conclusions:

    • Despite challenges and high reoperation rates, long-term outcomes for truncus arteriosus repair are generally favorable.
    • Improvements in perioperative care have enabled more children to reach adulthood with a good quality of life.
    • Ongoing research and surgical refinement are crucial for optimizing care in complex cases.