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Contemporary Multicenter Outcomes for Truncus Arteriosus With Interrupted Aortic Arch
Jason R Buckley1, John M Costello1, Arthur J Smerling2
1Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.
The Annals of Thoracic Surgery
|September 9, 2022
Summary
Truncus arteriosus with interrupted aortic arch (TA-IAA) repair had a high rate of major adverse cardiac events (MACE), but outcomes improved over time. Early childhood results for TA-IAA were similar to standard truncus arteriosus (TA) repair.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Truncus arteriosus with interrupted aortic arch (TA-IAA) is a rare congenital heart defect with historically poor outcomes.
- Contemporary multicenter data on TA-IAA repair outcomes are limited.
Approach:
- A retrospective cohort study analyzed 35 children undergoing TA-IAA repair from 2009-2016 across 12 US centers.
- Major adverse cardiac events (MACE) were defined as postoperative ECMO, CPR, or operative mortality.
- TA-IAA patients were compared to patients with standard truncus arteriosus (TA) repair.
Key Points:
- MACE occurred in 34% of TA-IAA patients, with a significant improvement observed over the study period.
- Factors associated with MACE included truncal valve insufficiency, truncal valve repair, and longer cardiopulmonary bypass duration.
- TA-IAA patients had a higher MACE rate than TA patients, though not statistically significant (34% vs. 20%).
Conclusions:
- TA-IAA repair is associated with a high MACE rate, but outcomes have improved.
- Early childhood outcomes for TA-IAA were similar to those for TA repair.
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