Branch Pulmonary Artery Reinterventions After Repair of Truncus Arteriosus

Conduit durability after repair of truncus arteriosus is dependent on right ventricle-to-pulmonary artery (RV-PA) conduit size and type. The role of branch pulmonary artery (PA) stenosis on RV-PA conduit longevity has not been well studied.

A single-center retrospective review was performed of patients who underwent repair of truncus arteriosus from 2001 to 2023. Patients were divided into 2 groups based on those who did (group 1) and did not (group 2) need early branch PA reintervention (before conduit reintervention/reoperation). The outcomes of interest were overall survival, conduit longevity, and burden of right ventricular outflow tract (RVOT) reinterventions.

Early branch PA reintervention was required in 25 of 118 patients (21.1%). There was no difference in clinical characteristics between those who required early branch PA reintervention (group 1) and those who did not (group 2) (P > .05). Overall survival (P = .323) and time to RVOT reintervention/reoperation (P = .232) did not differ between groups. However, the number of RVOT reinterventions/reoperations per patient-year was higher in group 1 (0.315 vs 0.158, P < .001). By multivariable analysis, early branch PA reintervention did not have a significant effect on survival or conduit longevity (P > .05).

Early branch PA reintervention after truncus repair does not adversely affect overall survival or conduit longevity but does confer a higher lifetime burden of RVOT reinterventions/reoperations.