Tronco común: variantes anatómicas, tratamiento quirúrgico y evolución / Truncus arteriosus, anatomy, surgical treatment, follow up

ABSTRACT

OBJECTIVE: To evaluate through a retrospective cohort the anatomy and results of patients that were operated of truncus arteriosus. MATERIAL AND METHODS: Historic cohort. From January 2000 to December 2005 twenty eight patients with troncus arteriosus were operated. RESULTS: There were fifteen male (53.6%) and 13 female patients (46.4%). The median age, at the time of the surgery, was 10.5 months. The median weight, at the time of the surgery was 6 kg. All the patients were dominant aortic. A woven-dacron tube was used in 25 cases, Hanckock to 2 and Barbero Marcial procedure in one. The media diameter for the tube for the 27 patients (96.4%) was of 14 +/- 2 mm. Two patients required aortic valvular replacement at the same time of the surgery and two more during follow up, after the first surgery. Fifty per cent of the patients had pulmonary hypertension crisis after de surgery. There were three deaths: one patient had cardiogenic shock; another had pulmonary hypertension and one more had obstruction of the traqueostomy cannula. During study monitoring, 3 patients (10.7%) needed interventionist procedures. One case needed dilatation of the tube and two cases needed dilatation of the pulmonary branches to implant a stent device. There has been one tube change 4.2 years after the correction. Actuarial survival after 30 days was of 96.42%, and 88.9% after one and five years. CONCLUSIONS: The surgical correction of the truncus arteriosus has allowed changing the natural history of this disease. Mortality is low however our follow up is not very long yet.