Surgical treatments of persistent truncus arteriosus / 中华胸心血管外科杂志

ABSTRACT

Objective:The purpose of this article was to assess the outcomes of different surgical methods of persistent truncus arteriosus(PTA)and to figure out the risk factors of mortality and reoperation.Methods:A retrospective review of pediatric patients(n=84) who underwent PTA repair between 2008 and 2018 at Shanghai Children’s Medical Center. There were 45 males and 39 females. Among them, five were neonates and 67 were infants(<1 year old). The PTA morphology, regarding to Van Praagh, type A1 in 36 patients, type A2 in 34 patients, type A3 in 7 and type A4 in 7. Right ventricular outflow tract reconstruction by autologous tissue was performed in 34 patients. Extracardiac conduits were used in 50 patients.Results:The mean cardiopulmonary bypass(CPB) and aortic cross-clamp time was(148.0±46.9) minutes and(91.0±25.9) minutes respectively. There were 13 early deaths and 3 late deaths. Time-related survival was 79.5% at 10 years. Multivariate analysis did not find any independent risk factor for early or late death. Sixteen patients received 19 reoperations, freedom from reoperation at 10 years was 10.8%. Infants younger than 3 months( P=0.014) and reconstructing a new pulmonary valve( P=0.021)were risk factors for reoperation. Conclusion:Patients achieved excellent results following repair of PTA, despite high reoperation rate. Lower weight, younger age, significant truncal valve regurgitation, repair of truncal valve and suffering from interrupted aortic arch or coronary artery anomalies were not risk factors for mortality. Younger age at repair and reconstructing a new pulmonary valve significantly increased the hazard of reoperation.