Subscribe to RSS
DOI: 10.1055/s-2003-42255
© Georg Thieme Verlag Stuttgart · New York
Long-term Results after Repair of Truncus Arteriosus Communis in Neonates and Infants
Presented in part at the 32nd Annual Meeting of the German Society of Thoracic and Cardiovascular Surgery, Leipzig, February 23 - 26, 2003Publication History
Received: February 27, 2003
Publication Date:
19 September 2003 (online)
Abstract
Background: We reviewed our experience of truncus arteriosus communis (TAC) repair. Methods: Between 05/90 and 10/01, 16 patients underwent complete repair of TAC (primary repair: group I, 12 patients, secondary repair: group II, 4 patients). Age was 2.4 months [5 days - 8.8 months] (median [range]) in group I, and 8.3 [5.6 - 13.5] years in group II. Continuity from the right ventricle to the pulmonary artery was achieved using a valved conduit. All patients had regular follow-up examinations. Results: There was one early death in each group (12.5%). Follow-up was 9 [1.2 - 12.7] years. Valved conduit failure occurred in 8 patients (67 %) in group I (group II, 1 patient, 33 %) requiring replacement at 2.5 [0.3 - 4.3] years (group II, 5.8 years). Severe neo-aortic valve regurgitation after truncal valve repair was observed in one patient, requiring valve replacement at 8.5 years in association with repeat homograft replacement (group I). Actual echocardiographic examination revealed normal ventricular function. Moderate conduit dysfunction was noted in 2 patients (group I). Conclusions: Complete repair of truncus arteriosus communis can be performed with excellent long-term results.
Key words
Truncus arteriosus communis - surgical repair - long-term results
References
- 1 Praagh R van, Praagh S van. The anatomy of common aorticopulmonary trunk (truncus arteriosus communis) and its embryologic implications. A study of 57 necropsy cases. Am J Cardiol. 1965; 16 406-425
- 2 Calder L, Praagh R van, Praagh S van. et al . Truncus arteriosus communis. Clinical, angiocardiographic, and pathologic findings in 100 patients. Am Heart J. 1976; 92 23-38
- 3 Anderson R H, Thiene G. Categorization and description of hearts with a common arterial trunk. Eur J Cardiothorac Surg. 1989; 3 481-487
- 4 McGoon D C, Rastelli G C, Ongley P A. An operation for the correction of truncus arteriosus. JAMA. 1968; 205 69-73
- 5 Ebert P A, Turley K, Stanger P, Hoffman J I, Heymann M A, Rudolph A M. Surgical treatment of truncus arteriosus in the first 6 months of life. Ann Surg. 1984; 200 451-456
- 6 Donato R M di, Fyfe D A, Puga F J. et al . Fifteen-year experience with surgical repair of truncus arteriosus. J Thorac Cardiovasc Surg. 1985; 89 414-422
- 7 Bove E L, Lupinetti F M, Pridjian A K. et al . Results of a policy of primary repair of truncus arteriosus in the neonate. J Thorac Cardiovasc Surg. 1993; 105 1057-1065
- 8 Hanley F L, Heinemann M K, Jonas R A. et al . Repair of truncus arteriosus in the neonate. J Thorac Cardiovasc Surg. 1993; 105 1047-1056
- 9 Lacour-Gayet F, Serraf A, Komiya T. et al . Truncus arteriosus repair: influence of techniques of right ventricular outflow tract reconstruction. J Thorac Cardiovasc Surg. 1996; 111 849-856
- 10 Rajasinghe H A, McElhinney D B, Reddy V M, Mora B N, Hanley F L. Long-term follow-up of truncus arteriosus repaired in infancy: a twenty-year experience. J Thorac Cardiovasc Surg. 1997; 113 869-878
- 11 Urban A E, Sinzobahamvya N, Brecher A M, Wetter J, Malorny S. Truncus arteriosus: ten-year experience with homograft repair in neonates and infants. Ann Thorac Surg. 1998; 66 S183-S188
- 12 Schreiber C, Eicken A, Balling G. et al . Single centre experience on primary correction of common arterial trunk: overall survival and freedom from reoperation after more than 15 years. Eur J Cardiothorac Surg. 2000; 18 68-73
- 13 Brown J W, Ruzmetov M, Okada Y, Vijay P, Turrentine M W. Truncus arteriosus repair: outcomes, risk factors, reoperation and management. Eur J Cardiothorac Surg. 2001; 20 221-227
- 14 Thompson L D, McElhinney D B, Reddy M, Petrossian E, Silverman N H, Hanley F L. Neonatal repair of truncus arteriosus: continuing improvement in outcomes. Ann Thorac Surg. 2001; 72 391-395
- 15 Collett R W, Edwards J E. Persistent truncus arteriosus: a classification according to anatomical types. Surg Clin North Am. 1948; 29 1245
- 16 McElhinney D B, Rajasinghe H A, Mora B N, Reddy V M, Silverman N H, Hanley F L. Reinterventions after repair of common arterial trunk in neonates and young infants. J Am Coll Cardiol. 2000; 35 1317-1322
- 17 Brizard C P, Cochrane A, Austin C, Nomura F, Karl T R. Management strategy and long-term outcome for truncus arteriosus. Eur J Cardiothorac Surg. 1997; 11 687-695
- 18 Ott D A, Eren E E, Huhta J C, Gutgesell H P. Surgical treatment for the type II and III truncus: complete division of the truncal root with primary repair using absorbable suture. Ann Thorac Surg. 1985; 40 201-204
- 19 Imamura M, Drummond-Webb J J, Sarris G E, Mee R B. Improving early and intermediate results of truncus arteriosus repair: a new technique of truncal valve repair. Ann Thorac Surg. 1999; 67 1142-1146
- 20 Barbero-Marcial M, Riso A, Atik E, Jatene A. A technique for correction of truncus arteriosus types I and II without extracardiac conduits. J Thorac Cardiovasc Surg. 1990; 99 364-369
Michael V. Ullmann,MD
Department of Cardiac Surgery, University of Heidelberg
Im Neuenheimer Feld 110
69120 Heidelberg
Germany
Phone: ++49/6221/566272
Fax: ++49/6221/565585
Email: michael.ullmann@urz.uni-heidelberg.de