Early- and mid-term outcomes of surgical repair of persistent truncus arteriosus in children_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZOU Minghui , MA Li , XIA Yuansheng , YANG Shengchun , CHEN Weidan , LI Wenlei ,  CHEN Xinxin

Department of Cardiac Surgery, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, 510623, P.R.China;

Corresponding author：

CHEN Xinxin, Email: zingerchen@163.com

Keywords：

Persistent truncus arteriosus; right ventricular outflow tract reconstruction; right ventricular outflow tract reconstruction; early- and mid-term results

DOI：

10.7507/1007-4848.201807032

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the early- and mid-term outcomes of surgical repair of persistent truncus arteriosus in children in a single institution of China.Methods The clinical data of 27 consecutive patients with persistent truncus arteriosus undergoing surgical repair in Guangzhou Women and Children’s Medical Center from November 2009 to May 2018 were retrospectively reviewed. There were 14 males and 13 females. Median age was 3.0 months (range: 13 days -11 years), of whom 10 (37.0%) were older than 6 months. Results There were three early deaths with a mortality of 11.1%. The main complications included VSD partial repair in 2 patients, complete atrioventricular block in one patient. The mean follow-up time was 24.5±19.3 months (range: 1–76 months). There were three late deaths, and two patients lost follow. Echocardiology showed seven patients of right heart outflow tract obstruction, including three in pulmonary artery trunk, and four of pulmonary artery branches. One patient showed moderate aortic valve regurgitation. None required re-intervention during the follow-up. Survival estimates for the entire cohort following surgery were both 76.1% (95%CI 59.2% to 92.9%) at 1 year and 5 years.Conclusion The surgical repair of persistent truncus arteriosus (PTA) remains challenges. The early- and mid-term outcomes of surgical repair of persistent truncus arteriosus are acceptable. For older children with severe pulmonary artery hypertension and/or trunk valve regurgitation, the risk of death is still higher. Some children have the higher risk of late right heart obstructive lesions.

Citation： ZOU Minghui, MA Li, XIA Yuansheng, YANG Shengchun, CHEN Weidan, LI Wenlei, CHEN Xinxin. Early- and mid-term outcomes of surgical repair of persistent truncus arteriosus in children. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(4): 321-325. doi: 10.7507/1007-4848.201807032 Copy

1.	Brown JW, Ruzmetov M, Okada Y, et al. Truncus arteriosus repair: outcomes, risk factors, reoperation and management. Eur J Cardiothorac Surg, 2001, 20(2): 221-227.
2.	邹明晖, 马力, 陈欣欣, 等. 扩大的端侧吻合一期修复主动脉弓中断诊治分析. 中华外科杂志, 2018, 56(3): 217-220.
3.	Naimo PS, Fricke TA, Yong MS, et al. Outcomes of truncus arteriosus repair in children: 35 years of experience from a single institution. Semin Thorac Cardiovasc Surg, 2016, 28(2): 500-511.
4.	Asagai S, Inai K, Shinohara T, et al. Long-term outcomes after truncus arteriosus repair: A single-center experience for more than 40 years. Congenit Heart Dis, 2016, 11(6): 672-677.
5.	Xu ZW, Shen J. Repair of truncus arteriosus: choice of right ventricle outflow reconstruction. J Card Surg, 2010, 25(6): 724-729.
6.	Zhang Y, Li SJ, Yan J, et al. Mid-term results after correction of type Ⅰ and type Ⅱ persistent truncus arteriosus in older patients. J Card Surg, 2012, 27(2): 228-230.
7.	Honjo O, Kotani Y, Akagi T, et al. Right ventricular outflow tract reconstruction in patients with persistent truncus arteriosus: a 15-year experience in a single Japanese center. Circ J, 2007, 71(11): 1776-1780.
8.	Sinzobahamvya N, Boscheinen M, Blaschczok HC, et al. Survival and reintervention after neonatal repair of truncus arteriosus with valved conduit. Eur J Cardiothorac Surg, 2008, 34(4): 732-737.
9.	Derby CD, Kolcz J, Gidding S, et al. Outcomes following non-valved autologous reconstruction of the right ventricular outflow tract in neonates and infants. Eur J Cardiothorac Surg, 2008, 34(4): 726-731.
10.	Danton MH, Barron DJ, Stumper O, et al. Repair of truncus arteriosus: a considered approach to right ventricular outflow tract reconstruction. Eur J Cardiothorac Surg, 2001, 20(1): 95-104.
11.	Nemoto S, Ozawa H, Sasaki T, et al. Repair of persistent truncus arteriosus without a conduit: sleeve resection of the pulmonary trunk from the aorta and direct right ventricle-pulmonary artery anastomosis. Eur J Cardiothorac Surg, 2011, 40(3): 563-568.
12.	Barbero-Marcial M, Riso A, Jatene A, et al. A technique for correction of truncus arteriosus types Ⅰ and Ⅱ without extracardiac conduits. J Thorac Cardiovasc Surg, 1990, 99(2): 364-369.
13.	Raisky O, Ben Ali W, Bajolle F, et al. Common arterial trunk repair: with conduit or without? Eur J Cardiothorac Surg, 2009, 36(4): 675-682.
14.	Hanley FL, Heinemann MK, Jonas RA, et al. Repair of truncus arteriosus in the neonate. J Thorac Cardiovasc Surg, 1993, 105(6): 1047-1056.
15.	Rajasinghe HA, McElhinney DB, Reddy VM, et al. Long-term follow-up of truncus arteriosus repaired in infancy: a twenty-year experience. J Thorac Cardiovasc Surg, 1997, 113(5): 869-879.
16.	Kaza AK, Burch PT, Pinto N, et al. Durability of truncal valve repair. Ann Thorac Surg, 2010, 90(4): 1307-1312.
17.	Russell HM, Pasquali SK, Jacobs JP, et al. Outcomes of repair of common arterial trunk with truncal valve surgery: a review of the society of thoracic surgeon’s congenital heart surgery database. Ann Thorac Surg, 2012, 93(1): 164-169.
18.	Mavroudis C, Backer CL. Surgical management of severe truncal insufficiency: experience with truncal valve remodeling techniques. Ann Thorac Surg, 2001, 72(2): 396-400.
19.	仇黎生, 孙彦隽, 刘锦纷, 等. 小儿永存动脉干外科治疗 54 例分析. 中华外科杂志, 2012, 50(9): 827-830.
20.	张岩, 李守军, 闫军, 等. Ⅰ 型和 Ⅱ 型永存动脉干的外科治疗结果及随访分析. 中国胸心血管外科临床杂志, 2012, 19(1): 19-21.
21.	王潇, 金晶, 陶凉, 等. 错过最佳手术时机永存动脉干患者的外科治疗. 中国胸心血管外科临床杂志, 2013, 20(3): 269-272.

1. Brown JW, Ruzmetov M, Okada Y, et al. Truncus arteriosus repair: outcomes, risk factors, reoperation and management. Eur J Cardiothorac Surg, 2001, 20(2): 221-227.
2. 邹明晖, 马力, 陈欣欣, 等. 扩大的端侧吻合一期修复主动脉弓中断诊治分析. 中华外科杂志, 2018, 56(3): 217-220.
3. Naimo PS, Fricke TA, Yong MS, et al. Outcomes of truncus arteriosus repair in children: 35 years of experience from a single institution. Semin Thorac Cardiovasc Surg, 2016, 28(2): 500-511.
4. Asagai S, Inai K, Shinohara T, et al. Long-term outcomes after truncus arteriosus repair: A single-center experience for more than 40 years. Congenit Heart Dis, 2016, 11(6): 672-677.
5. Xu ZW, Shen J. Repair of truncus arteriosus: choice of right ventricle outflow reconstruction. J Card Surg, 2010, 25(6): 724-729.
6. Zhang Y, Li SJ, Yan J, et al. Mid-term results after correction of type Ⅰ and type Ⅱ persistent truncus arteriosus in older patients. J Card Surg, 2012, 27(2): 228-230.
7. Honjo O, Kotani Y, Akagi T, et al. Right ventricular outflow tract reconstruction in patients with persistent truncus arteriosus: a 15-year experience in a single Japanese center. Circ J, 2007, 71(11): 1776-1780.
8. Sinzobahamvya N, Boscheinen M, Blaschczok HC, et al. Survival and reintervention after neonatal repair of truncus arteriosus with valved conduit. Eur J Cardiothorac Surg, 2008, 34(4): 732-737.
9. Derby CD, Kolcz J, Gidding S, et al. Outcomes following non-valved autologous reconstruction of the right ventricular outflow tract in neonates and infants. Eur J Cardiothorac Surg, 2008, 34(4): 726-731.
10. Danton MH, Barron DJ, Stumper O, et al. Repair of truncus arteriosus: a considered approach to right ventricular outflow tract reconstruction. Eur J Cardiothorac Surg, 2001, 20(1): 95-104.
11. Nemoto S, Ozawa H, Sasaki T, et al. Repair of persistent truncus arteriosus without a conduit: sleeve resection of the pulmonary trunk from the aorta and direct right ventricle-pulmonary artery anastomosis. Eur J Cardiothorac Surg, 2011, 40(3): 563-568.
12. Barbero-Marcial M, Riso A, Jatene A, et al. A technique for correction of truncus arteriosus types Ⅰ and Ⅱ without extracardiac conduits. J Thorac Cardiovasc Surg, 1990, 99(2): 364-369.
13. Raisky O, Ben Ali W, Bajolle F, et al. Common arterial trunk repair: with conduit or without? Eur J Cardiothorac Surg, 2009, 36(4): 675-682.
14. Hanley FL, Heinemann MK, Jonas RA, et al. Repair of truncus arteriosus in the neonate. J Thorac Cardiovasc Surg, 1993, 105(6): 1047-1056.
15. Rajasinghe HA, McElhinney DB, Reddy VM, et al. Long-term follow-up of truncus arteriosus repaired in infancy: a twenty-year experience. J Thorac Cardiovasc Surg, 1997, 113(5): 869-879.
16. Kaza AK, Burch PT, Pinto N, et al. Durability of truncal valve repair. Ann Thorac Surg, 2010, 90(4): 1307-1312.
17. Russell HM, Pasquali SK, Jacobs JP, et al. Outcomes of repair of common arterial trunk with truncal valve surgery: a review of the society of thoracic surgeon’s congenital heart surgery database. Ann Thorac Surg, 2012, 93(1): 164-169.
18. Mavroudis C, Backer CL. Surgical management of severe truncal insufficiency: experience with truncal valve remodeling techniques. Ann Thorac Surg, 2001, 72(2): 396-400.
19. 仇黎生, 孙彦隽, 刘锦纷, 等. 小儿永存动脉干外科治疗 54 例分析. 中华外科杂志, 2012, 50(9): 827-830.
20. 张岩, 李守军, 闫军, 等. Ⅰ 型和 Ⅱ 型永存动脉干的外科治疗结果及随访分析. 中国胸心血管外科临床杂志, 2012, 19(1): 19-21.
21. 王潇, 金晶, 陶凉, 等. 错过最佳手术时机永存动脉干患者的外科治疗. 中国胸心血管外科临床杂志, 2013, 20(3): 269-272.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Early- and mid-term outcomes of surgical repair of persistent truncus arteriosus in children

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content