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The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 1047-1056, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
FL Hanley, MK Heinemann, RA Jonas, JE Mayer Jr, NR Cook, DL Wessel and AR Castaneda
From September 1986 through December 1991, 63 patients with truncus
arteriosus underwent surgical repair. The management approach evolved over
the period of the study from elective primary repair at 3 months of age to
elective primary repair in the early neonatal period. Thirty variables were
examined as potential risk factors for the outcome events of death,
reoperation, and presence of pulmonary vascular morbidity. According to
both univariate and multivariate techniques, severe truncal valve
regurgitation, interrupted aortic arch, coronary artery anomalies, and age
at repair greater than 100 days were important risk factors for
perioperative death. In the 33 patients without these risk factors, early
survival was 100%. In the 30 patients with one or more of these risk
factors, survival was 63%. Pulmonary hypertensive episodes were fewer, and
duration of ventilator dependence and pulmonary artery pressure were
significantly less in patients undergoing the operation before 30 days of
age. Seven patients required reoperation for right ventricular outflow
tract obstruction at a mean follow-up time of 23.4 months, with no deaths.
In conclusion, interrupted aortic arch, severe truncal valve insufficiency,
coronary anomalies, and repair later than 100 days of age were risk factors
for death after repair of truncus arteriosus. In the absence of these
associations, truncus arteriosus can be repaired with excellent surgical
outcome in the neonatal and early infancy period. Repair in the early
neonatal period reduces the prevalence of postoperative pulmonary vascular
morbidity.
ARTICLES
Repair of truncus arteriosus in the neonate
Department of Cardiovascular Surgery, Harvard Medical School, Children's Hospital of Boston, Mass.
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M. Jahangiri, D. Zurakowski, J. E. Mayer, P. J. del Nido, and R. A. Jonas REPAIR OF THE TRUNCAL VALVE AND ASSOCIATED INTERRUPTED ARCH IN NEONATES WITH TRUNCUS ARTERIOSUS J. Thorac. Cardiovasc. Surg., March 1, 2000; 119(3): 508 - 514. [Abstract] [Full Text] [PDF]
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E. Malec, T. Mroczek, J. Pajak, and Z. Kordon Operative treatment of truncus arteriosus communis coexisting with tricuspid atresia Ann. Thorac. Surg., January 1, 2000; 69(1): 278 - 280. [Abstract] [Full Text] [PDF]
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J. M. Williams, M. de Leeuw, M. D. Black, R. M. Freedom, W. G. Williams, and B. W. McCrindle Factors associated with outcomes of persistent truncus arteriosus J. Am. Coll. Cardiol., August 1, 1999; 34(2): 545 - 553. [Abstract] [Full Text] [PDF]
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J. Perron, A. M. Moran, K. Gauvreau, P. J. del Nido, J. E. Mayer Jr, and R. A. Jonas Valved homograft conduit repair of the right heart in early infancy Ann. Thorac. Surg., August 1, 1999; 68(2): 542 - 548. [Abstract] [Full Text] [PDF]
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C. Mavroudis, M. Gevitz, W. S. Ring, C. L. McIntosh, and M. Schwartz The Society of Thoracic Surgeons national congenital heart surgery database report: : Analysis of the first harvest (1994-1997) Ann. Thorac. Surg., August 1, 1999; 68(2): 601 - 624. [Abstract] [Full Text] [PDF]
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M. Imamura, J. J. Drummond-Webb, G. E. Sarris, and R. B.B. Mee Improving early and intermediate results of truncus arteriosus repair: a new technique of truncal valve repair Ann. Thorac. Surg., April 1, 1999; 67(4): 1142 - 1146. [Abstract] [Full Text] [PDF]
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W. Tworetzky, D. B. McElhinney, M. M. Brook, V. Mohan Reddy, F. L. Hanley, and N. H. Silverman Echocardiographic diagnosis alone for the complete repair of major congenital heart defects J. Am. Coll. Cardiol., January 1, 1999; 33(1): 228 - 233. [Abstract] [Full Text] [PDF]
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T. Katsumata, A. Shinfeld, and S. Westaby Temporary Aorto-Pulmonary Shunt for Pulmonary Hypertension After Truncus Arteriosus Repair Ann. Thorac. Surg., June 1, 1998; 65(6): 1764 - 1765. [Abstract] [Full Text] [PDF]
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D. B. McElhinney, V. M. Reddy, H. A. Rajasinghe, B. N. Mora, N. H. Silverman, and F. L. Hanley Trends in the Management of Truncal Valve Insufficiency Ann. Thorac. Surg., February 1, 1998; 65(2): 517 - 524. [Abstract] [Full Text] [PDF]
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D. M. Mello, D. B. McElhinney, A. J. Parry, N. H. Silverman, and F. L. Hanley Truncus Arteriosus With Patent Ductus Arteriosus and Normal Aortic Arch Ann. Thorac. Surg., December 1, 1997; 64(6): 1808 - 1810. [Abstract] [Full Text]
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S. Conte, T. Jensen, J. R. Jacobsen, F. S. Joyce, P. Lauridsen, and G. Pettersson One-Stage Repair of Truncus Arteriosus, CAVC, and TAPVC Ann. Thorac. Surg., June 1, 1997; 63(6): 1781 - 1783. [Abstract] [Full Text]
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H. A. Rajasinghe, D. B. McElhinney, V. M. Reddy, B. N. Mora, and F. L. Hanley LONG-TERM FOLLOW-UP OF TRUNCUS ARTERIOSUS REPAIRED IN INFANCY: A TWENTY-YEAR EXPERIENCE J. Thorac. Cardiovasc. Surg., May 1, 1997; 113(5): 869 - 879. [Abstract] [Full Text]
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K. Bando, M. W. Turrentine, T. G. Sharp, Y. Sekine, T. X. Aufiero, K. Sun, E. Sekine, and J. W. Brown PULMONARY HYPERTENSION AFTER OPERATIONS FOR CONGENITAL HEART DISEASE: ANALYSIS OF RISK FACTORS AND MANAGEMENT J. Thorac. Cardiovasc. Surg., December 1, 1996; 112(6): 1600 - 1609. [Abstract] [Full Text]
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L. A. Skaryak, A. J. Lodge, P. M. Kirshbom, L. R. DiBernardo, B. G. Wilson, J. N. Meliones, R. M. Ungerleider, and J. W. Gaynor Low-Flow Cardiopulmonary Bypass Produces Greater Pulmonary Dysfunction Than Circulatory Arrest Ann. Thorac. Surg., November 1, 1996; 62(5): 1284 - 1288. [Abstract] [Full Text]
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S. Nakae, S. Kasahara, N. Kuroyama, Z.-B. Lin, S. Hiraishi, Y. Agata, and H. Yoshimura Correction of Truncus Arteriosus With Autologous Arterial Flap in Neonates and Small Infants Ann. Thorac. Surg., July 1, 1996; 62(1): 123 - 128. [Abstract] [Full Text]
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F. L. Hanley Invited Commentary Ann. Thorac. Surg., July 1, 1996; 62(1): 129 - 129. [Full Text]
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F. Lacour-Gayet, A. Serraf, T. Komiya, M. Sousa-Uva, J. Bruniaux, A. Touchot, D. Roux, P. Neuville, and C. Planche TRUNCUS ARTERIOSUS REPAIR: INFLUENCE OF TECHNIQUES OF RIGHT VENTRICULAR OUTFLOW TRACT RECONSTRUCTION J. Thorac. Cardiovasc. Surg., April 1, 1996; 111(4): 849 - 856. [Abstract] [Full Text]
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