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Right Ventricular Outflow Tract Reconstruction in Truncus Arteriosus-With or Without a Conduit? A Systematic Review
Kristine Santos1, Bezalel Hakkeem2, Hellen Pereira3
1New Vision University School of Medicine, Tbilisi, Georgia.
World Journal for Pediatric & Congenital Heart Surgery
|February 4, 2026
Summary
Conduit-based (CB) and nonconduit-based (NCB) strategies for truncus arteriosus (TA) repair show similar survival. However, CB reconstruction has a higher reoperation and reintervention rate, suggesting NCB may offer better long-term durability.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Surgical Outcomes Research
Background:
- Surgical repair of truncus arteriosus (TA) necessitates establishing right ventricle-to-pulmonary artery (RVOT) continuity.
- Two primary strategies exist: conduit-based (CB) and nonconduit-based (NCB) reconstruction.
- The optimal RVOT strategy remains a subject of debate.
Purpose of the Study:
- To compare the clinical outcomes of conduit-based (CB) versus nonconduit-based (NCB) RVOT reconstruction techniques in the primary surgical repair of truncus arteriosus (TA).
- To evaluate differences in mortality, reoperation rates, and reintervention rates between the two approaches.
Main Methods:
- A systematic literature search was conducted to identify studies comparing CB and NCB RVOT reconstruction for primary TA repair.
- Meta-analysis was performed using RevMan 8.13.0, reporting effect estimates as odds ratios (ORs) and mean differences with 95% confidence intervals (CIs).
- Seven studies involving 360 patients were included in the analysis.
Main Results:
- No significant differences were found in early or long-term mortality between CB and NCB groups.
- The incidence of right ventricular outflow tract (RVOT) reoperation was significantly higher in the CB cohort (OR 3.70; P=.003).
- Overall reintervention rates, including surgical and catheter-based procedures, were also significantly higher with CB reconstruction (OR 2.45; P=.01).
Conclusions:
- Both CB and NCB RVOT reconstruction techniques provide comparable early and long-term survival for truncus arteriosus repair.
- Conduit-based reconstruction is associated with a substantially increased risk of RVOT reoperation and overall reintervention.
- Nonconduit-based approaches may offer superior long-term durability, potentially reducing the need for subsequent interventions in neonates undergoing primary TA repair.
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