Surgical outcomes of common arterial trunk repair beyond infancy.

Background: The aim of this study is to analyze the clinical outcomes of common arterial trunk repair beyond infancy in terms of both early- and long-term outcomes. Methods: Between January 2003 and December 2019, 56 patients underwent repair for common arterial trunk beyond infancy at our institute. Median age was 34.5 months, 51.8% were females, and 48.2% were males. Results: 48.2% were type 1, 46.4% were type 2, and 5.4% were type 3. 17.9% patients underwent direct connection technique for right ventricular outflow tract reconstruction; remaining received a conduit. The most common type of truncal valve anatomy was tricuspid (82.1%). Early mortality was 7%. Univariable analysis identified age (p = 0.003), weight (p = 0.04), duration of ventilation (p = 0.036), and pulmonary hypertensive crisis (p ≤ 0.001) as factors affecting early mortality. In our overall cohort of beyond infancy repair for common arterial trunk, at 10 years, the survival, freedom from reintervention for right ventricular outflow tract reconstruction, freedom from ≥ moderate conduit obstruction, freedom from impaired right ventricle function, and freedom from ≥ moderate truncal valve regurgitation were 76.7%, 89.7%, 74%, 88.6%, and 66.3%, respectively. Conclusion: Repair for common arterial trunk in patients presenting beyond 1 year of age is challenging; however, it can be done with satisfactory early and late outcomes in terms of mortality and reintervention.

Cerebral embolic shower secondary to BioGlue use in triple valve surgery.

Hemostasis is a crucial step in cardiac surgery which determines postoperative outcomes. Tissue sealants and glues are necessary to achieve hemostasis in situations where conventional methods are unsuccessful. BioGlue, a commonly used topical hemostatic agent, has been reported to cause systemic embolic complications. We report a case of cerebral embolic shower following the use of BioGlue for posterior aortic suture line bleeding in a 49-year-old lady who underwent triple valve surgery. This report brings to light a rare but devastating complication of BioGlue usage in the present era of complex aortic surgeries. We also postulate a mechanism for BioGlue embolization.