Mid-term Outcomes after Correction of Type Ⅰ and Type Ⅱ Persistent Truncus Arteriosus_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Yan , LI Shoujun , YAN Jun

Department of Cardiac Surgery，Fu Wai Cardiovascular Hospital and Cardiovascular Institute，Chinese Academy of Medical Sciences &;
Peking Union Medical College，Beijing 100037，P. R. China;

Corresponding author：

Keywords：

Congenital heart disease; Persistent truncus arteriosus; Surgery; Follow-up

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Abstract： Objective To analyze the mid-term outcomes after correction of type Ⅰ and type Ⅱ persistent truncus arteriosus in all patients operated in our institution over the past 5 years. Methods Between May 2006 and October 2010, 17 patients, mean age 4.7（ 0.7-19.0）years, underwent repair of truncus arteriosus（ type Ⅰ in 13 and type Ⅱ in 4） in Fu Wai Cardiovascular Hospital. Some other concomitant cardiovascular malformations included truncal valve regurgitation, partial anomalous pulmonary venous connection, mitral regurgitation and atrial septal defect. Their average pulmonary vascular resistance was （4.4±2.2） Wood units detected by cardiac catheterization before operation. Repair with reconstruction of the right ventricular to pulmonary artery continuity was performed using a valved conduit in all 17 patients （aortic homografts in 3, pulmonary homografts in 2, and bovine jugular vein in 12 patients）. Survivors were followed up for assessment of residual heart lesions. Results The early mortality was 5.8% （1/17）. The mean cardiopulmonary bypass time was （165±52） min, mean aortic cross-clamping time was （114±29） min, and mean postoperative ventilation time was （106±148） h. Two patients had pleural effusion after surgery, 2 patients underwent tracheostomy, and other patients recovered uneventfully. The surviving 16 patients were followed up for 0.6-5.0 years. All patients were alive with their original conduit during follow-up. No patient required re-operation for conduit dysfunction after correction. Conclusion Truncus arteriosus remains a challenging congenital heart disease. For patients with type Ⅰ and type Ⅱ persistent truncus arteriosus who have missed their best age for correction, cardiac catheterization should be routinely examined, and the operation should be performed if the pulmonary vascular resistance is under 8 Wood units before operation. Although the short- and mid-term results of surgery are good, more observations are needed to assess its long-term effect.

Citation： ZHANG Yan,LI Shoujun,YAN Jun,et al .. Mid-term Outcomes after Correction of Type Ⅰ and Type Ⅱ Persistent Truncus Arteriosus. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(1): 19-21. doi: Copy

1.	Kirklin JW, Barrat-Boyes BG, eds. Truncus Arteriosus. Cardiac Surgery. 3rd edition, New York： Churchill Livingstone. 2003.1200-1221.
2.	McGoon D, Rastelli GC, Ongley PA. An operation for the correction of truncus arteriosus. JAMA,1968,205（2）: 69-73.
3.	Di Donato RM, Fyfe DA, Puga FJ, et al. Fifteen-year experience with surgical repair of truncus arteriosus. J Thorac Cardiovasc Surg, 1985, 89（3）: 414-422.
4.	Jacobs JP, O’Brien SM, Pasquali SK, et al. Variation in outcomes for benchmark operations： an analysis of the society of thoracic surgeons congenital heart surgery database. Ann Thorac Surg, 2011, 92（6）: 2184-2192.
5.	Park CS, Jhang WK, Ko JK, et al. Lecompte operation： is it still a viable option for truncus arteriosus? J Thorac Cardiovasc Surg , 2008, 136（5）: 1384-1386.
6.	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.
7.	Kaczmarek I, Schmauss D, Reichart B, et al. Complete autologous reconstruction of the aorta and the pulmonary bifurcation in truncus arteriosus communis. Eur J Cardiothorac Surg， 2006，30（4）: 675-677.
8.	Lecompte Y, Neveux JY, Leca F, et al. Reconstruction of the pulmonary outflow tract without prosthetic conduit. J Thorac Cardiovasc Surg，1982，84（5）: 727-733.
9.	沈佳，徐志伟. 永存动脉干纠治术中右心室流出道重建方式的选择. 中国胸心血管外科临床杂志，2008, 15（2）: 81-86.
10.	Williams JM, de Leeuw M, Black MD, et al. Factors associated with outcomes of persistent truncus arteriosus. J Am Coll Cardiol, 1999，34（2）：545-553.
11.	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）: 869-878.
12.	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.
13.	Hickey EJ, McCrindle BW, Blackstone EH, et al. Jugular venous valved conduit（Contegra） matches allograft performance in infant truncus arteriosus repair. Eur J Cardiothorac Surg, 2008, 33（5）: 890-898.
14.	Tlaskal T, Chaloupecky V, Hucin B, et al. Longterm results after correction of persistent truncus arteriosus in 83 patients. Eur J Cardiothorac Surg, 2010, 37（6）: 1278-1284.
15.	Henaine R, Azarnoush K, Belli E, et al. Fate of the truncal valve in truncus arteriosus. Ann Thorac Surg, 2008, 85（1）: 172-178.

1. 　Kirklin JW, Barrat-Boyes BG, eds. Truncus Arteriosus. Cardiac Surgery. 3rd edition, New York： Churchill Livingstone. 2003.1200-1221.
2. 　McGoon D, Rastelli GC, Ongley PA. An operation for the correction of truncus arteriosus. JAMA,1968,205（2）: 69-73.
3. 　Di Donato RM, Fyfe DA, Puga FJ, et al. Fifteen-year experience with surgical repair of truncus arteriosus. J Thorac Cardiovasc Surg, 1985, 89（3）: 414-422.
4. 　Jacobs JP, O’Brien SM, Pasquali SK, et al. Variation in outcomes for benchmark operations： an analysis of the society of thoracic surgeons congenital heart surgery database. Ann Thorac Surg, 2011, 92（6）: 2184-2192.
5. 　Park CS, Jhang WK, Ko JK, et al. Lecompte operation： is it still a viable option for truncus arteriosus? J Thorac Cardiovasc Surg , 2008, 136（5）: 1384-1386.
6. 　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.
7. 　Kaczmarek I, Schmauss D, Reichart B, et al. Complete autologous reconstruction of the aorta and the pulmonary bifurcation in truncus arteriosus communis. Eur J Cardiothorac Surg， 2006，30（4）: 675-677.
8. 　Lecompte Y, Neveux JY, Leca F, et al. Reconstruction of the pulmonary outflow tract without prosthetic conduit. J Thorac Cardiovasc Surg，1982，84（5）: 727-733.
9. 　沈佳，徐志伟. 永存动脉干纠治术中右心室流出道重建方式的选择. 中国胸心血管外科临床杂志，2008, 15（2）: 81-86.
10. 　Williams JM, de Leeuw M, Black MD, et al. Factors associated with outcomes of persistent truncus arteriosus. J Am Coll Cardiol, 1999，34（2）：545-553.
11. 　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）: 869-878.
12. 　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.
13. 　Hickey EJ, McCrindle BW, Blackstone EH, et al. Jugular venous valved conduit（Contegra） matches allograft performance in infant truncus arteriosus repair. Eur J Cardiothorac Surg, 2008, 33（5）: 890-898.
14. 　Tlaskal T, Chaloupecky V, Hucin B, et al. Longterm results after correction of persistent truncus arteriosus in 83 patients. Eur J Cardiothorac Surg, 2010, 37（6）: 1278-1284.
15. 　Henaine R, Azarnoush K, Belli E, et al. Fate of the truncal valve in truncus arteriosus. Ann Thorac Surg, 2008, 85（1）: 172-178.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Mid-term Outcomes after Correction of Type Ⅰ and Type Ⅱ Persistent Truncus Arteriosus

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