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Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Timing the Repair in Truncus Arteriosus: A Systematic Review and Meta-analysis with Reconstructed Time-to-Event Data

Kristine Santos1, Wellgner Fernandes Oliveira Amador2, Sriharsha Koduru3

  • 1New Vision University School of Medicine, Tbilisi, Georgia.

World Journal for Pediatric & Congenital Heart Surgery
|April 7, 2026
PubMed
Summary

Staged repair (SR) for Truncus arteriosus (TA) shows fewer late reoperations compared to primary correction (PC), with similar survival and perioperative outcomes. Evidence is limited, requiring cautious interpretation of these findings.

Keywords:
common arterial trunkcongenital heart diseaseprimary correctionstaged repairtruncus arteriosus

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease Surgery

Background:

  • Truncus arteriosus (TA) is a rare congenital heart defect requiring surgical intervention.
  • Current surgical strategies include single-stage primary correction (PC) and staged repair (SR).
  • The optimal surgical approach for TA remains a subject of debate.

Purpose of the Study:

  • To systematically compare the outcomes of staged repair (SR) versus primary correction (PC) for Truncus arteriosus.
  • To evaluate reoperation rates, survival, and perioperative outcomes between SR and PC.

Main Methods:

  • Systematic literature search and meta-analysis of five comparative studies involving 534 pediatric patients.
  • Pooled odds ratios (ORs) and hazard ratios (HRs) were calculated for reoperation and mortality.
  • Kaplan-Meier curves were reconstructed to assess freedom from reoperation over time.

Main Results:

  • Staged repair (SR) was associated with significantly lower rates of unplanned reoperations at 12-year follow-up (OR 0.28; P=.02).
  • No significant difference in overall mortality was observed between SR and PC (OR 0.59; P=.32).
  • Perioperative outcomes, including bypass times, intubation duration, and hospital stay, were similar between the two approaches.

Conclusions:

  • Staged repair (SR) may offer an advantage in reducing late reoperations for Truncus arteriosus compared to primary correction (PC).
  • Survival and early perioperative outcomes appear comparable between SR and PC.
  • The findings are based on low-certainty evidence from limited retrospective studies, necessitating cautious interpretation.