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Updated: Nov 29, 2025

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Coronary Artery Anomalies Are Associated With Increased Mortality After Truncus Arteriosus Repair

Carlos Bonilla-Ramirez1, Christopher Ibarra1, Ziyad M Binsalamah1

  • 1Division of Congenital Heart Surgery, Texas Children's Hospital, Department of Surgery, Baylor College of Medicine, Houston, Texas.

The Annals of Thoracic Surgery
|November 20, 2020
PubMed

Insights

The number of coronary artery lesions in patients undergoing truncus arteriosus repair significantly impacts mortality. Surgical intervention may improve survival for those with one or two lesions, but complex cases with three lesions have poor outcomes.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Congenital Heart Disease

Background:

  • Truncus arteriosus frequently presents with associated coronary artery anomalies.
  • Identifying and characterizing these coronary lesions is crucial for surgical planning and patient outcomes.

Purpose of the Study:

  • To identify coronary artery lesions in patients undergoing truncus arteriosus repair.
  • To define the impact of these lesions on mortality.
  • To study the effect of surgical intervention on coronary lesions.

Main Methods:

  • Retrospective review of 107 patients who underwent truncus arteriosus repair between 1995 and 2019.
  • Categorization of coronary lesions: ostial stenosis, intramural, juxtacommissural origin, and single coronary.
  • Survival analysis to assess the association between coronary lesions and mortality.

Main Results:

  • 34 out of 107 patients had at least one coronary lesion.
  • Coronary lesions, including ostial stenosis, intramurality, and juxtacommissural origin, were linked to increased mortality.
  • Survival decreased significantly with an increasing number of coronary lesions (8% for 3 lesions vs. 85% overall 5-year survival).
  • Surgical intervention on 1-2 coronary lesions showed a trend towards improved survival (100% vs. 62%).

Conclusions:

  • The number of coronary lesions is directly correlated with mortality risk after truncus arteriosus repair.
  • Coronary artery intervention may improve survival for patients with one or two lesions.
  • Patients with three coronary lesions face poor survival, necessitating further research into advanced repair techniques.
Abstract

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