Truncus arteriosus repair: A 40-year multicenter perspective

Abstract

OBJECTIVE: To examine the long-term surgical outcomes of patients who underwent truncus arteriosus (TA) repair. METHODS: Between 1979 and 2018, a total of 255 patients underwent TA repair at 3 Australian hospitals. Data were obtained by review of medical records from initial admission until last cardiology follow-up. RESULTS: At the time of TA repair, the median patient age was 44 days, and median weight was 3.5 kg. Early mortality was 13.3% (34 of 255), and overall survival was 76.8 ± 2.9% at 20 years. Neonatal surgery and low operative weight were risk factors for early mortality. Most deaths (82.5%; 47 of 57) occurred within the first year following repair. A coronary artery anomaly and early reoperation were identified as risk factors for late mortality. A total of 175 patients required at least 1 reoperation, with overall freedom of reoperation of 2.9 ± 1.5% at 20 years. Follow-up of survivors was 96% complete (191 of 198). The median duration of follow-up was 16.4 years. At the last follow-up, 190 patients were categorized as New York Heart Association class I/II, and 1 patient was class III. CONCLUSIONS: TA repair during the neonatal period presents significant surgical challenges. Neonates with signs of overcirculation should be operated on promptly. A coronary artery anomaly is a risk factor for late mortality. Survival beyond the first year following repair is associated with excellent outcomes.1097-685xNaimo, Phillip S <br />Bell, Douglas <br />Fricke, Tyson A <br />d'Udekem, Yves <br />Brizard, Christian P <br />Alphonso, Nelson <br />Konstantinov, Igor E <br />Journal Article <br />United States <br />J Thorac Cardiovasc Surg. 2020 May 15:S0022-5223(20)31137-5. doi: 10.1016/j.jtcvs.2020.04.149. <br />