Death, reoperation, and late cardiopulmonary function after truncus repair

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Truncus arteriosus is a rare congenital heart defect requiring surgical intervention.
• Long-term outcomes and prognostic factors after surgical repair are crucial for patient management.

Purpose of the Study:

• To evaluate the late surgical outcomes of truncus arteriosus repair.
• To identify risk factors influencing survival and reoperation rates.
• To assess the functional status, including exercise capacity, of long-term survivors.

Main Methods:

• Retrospective cohort study of 50 consecutive patients with truncus arteriosus undergoing surgery between 1978 and 2020.
• Primary outcomes included death and reoperation; secondary outcomes assessed late clinical status and exercise capacity via treadmill testing.
• Statistical analysis identified risk factors for survival and reoperation.

Main Results:

• The 30-year survival rate after truncus arteriosus repair was 68.5%.
• Significant truncal valve regurgitation was identified as a risk factor for both survival (P=.030) and reoperation (P=.001).
• The freedom from death or reoperation rate at 15 years was 35.8%; long-term survivors (n=12) showed a peak oxygen uptake of 70.2% of predicted normal.

Conclusions:

• Truncal valve regurgitation significantly impacts survival and reoperation rates, highlighting the need for improved truncal valve surgery techniques.
• While long-term survival is achievable, a proportion of patients experience slightly reduced exercise tolerance, emphasizing the importance of ongoing monitoring and quality of life assessment.