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. 2023 Mar 5;56(2):75-86.
doi: 10.5090/jcs.22.106. Epub 2023 Jan 30.

Outcomes of Surgical Repair for Truncus Arteriosus: A 30-Year Single-Center Experience

Yu Ri Lee  1 , Dong-Hee Kim  1   2 , Eun Seok Choi  1   2 , Tae-Jin Yun  1   2 , Chun Soo Park  1   2
Affiliations

Outcomes of Surgical Repair for Truncus Arteriosus: A 30-Year Single-Center Experience

Yu Ri Lee et al. J Chest Surg. .

Abstract

Background: We investigated the long-term outcomes of truncus arteriosus repair at a single institution with a 30-year study period.

Methods: Patients who underwent repair of truncus arteriosus between 1993 and 2022 were reviewed retrospectively. Factors associated with early mortality, overall attrition, and reintervention were identified using appropriate statistical methods.

Results: In total, 42 patients were enrolled in this study. The median age and weight at repair were 26 days and 3.5 kg, respectively. Thirty patients (71.4%) underwent 1-stage repair. There were 8 early deaths (19%). In the univariable analysis, undergoing surgery before 2011 was associated with early mortality (p=0.031). The overall survival rate at 10 years was 73.8%. In the multivariable analysis, significant truncal valve (TrV) dysfunction (p=0.010), longer cardiopulmonary bypass time (p=0.018), and the earlier era of surgery (p=0.004) were identified as risk factors for overall mortality. During follow-up, 47 reinterventions were required in 27 patients (64.3%). The freedom from all-cause reintervention rate at 10 years was 23.6%. In the multivariable analysis, associated arch obstruction (p<0.001) and significant TrV dysfunction (p=0.011) were identified as risk factors for all-cause reintervention. Arch obstruction (p=0.027) and a number of TrV cusps other than 3 (p=0.014) were identified as risk factors for right ventricle to pulmonary artery (RV-PA) reintervention, and significant TrV dysfunction was identified as a risk factor for TrV reintervention (p=0.002).

Conclusion: Despite recent improvements in survival outcomes after repair of truncus arteriosus, RV-PA or TrV reinterventions were required in a significant number of patients during follow-up.

Keywords: Long-term outcome; Reintervention; Risk factors; Truncus arteriosus.

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Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Kaplan-Meier curves for survival and reintervention. (A) Overall survival. (B) Overall survival according to the era of surgery. (C) Freedom from all-cause reintervention. (D) Freedom from right ventricle to pulmonary artery reintervention. (E) Freedom from truncal valve reintervention.
See this image and copyright information in PMC

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