Management of truncal valvular regurgitation

The presence of significant truncal valvular regurgitation presents a technically difficult and life-threatening challenge during operations for correction of the truncus arteriosus anomaly. The problem was encountered in 19 of 71 patients (26%) who underwent such operations. A simple technique for managing this problem, namely, temporary cusp approximation, has evolved and has proved successful in all 11 patients in which it was used. The indications for replacement of the regurgitant truncal valve have not yet been defined. The suggestion is made that in all but the most severe instances of truncal valvular regurgitation, persistence of the regurgitation postoperatively may currently be preferable to replacement of the valve.