title: Repair of persistent truncus arteriosus with interrupted aortic arch.
abstract: OBJECTIVE
  The aim of our study was to analyse experience with repair of truncus arteriosus with interrupted aortic arch.
  
  
  METHODS
  Between 1993 and 2004, eight consecutive patients underwent repair of truncus arteriosus with interrupted aortic arch. The median age was 6.5 days (range 1-85 days) and median weight was 3.2 kg (range 2.6-4.8 kg). Five patients had type A and 3 patients had type B aortic arch interruption. The repair was performed in deep hypothermia with circulatory arrest in 4 patients and isolated selective low-flow perfusion of the head and the heart in the last 4 patients. The repair consisted in aortic arch reconstruction by direct anastomosis between descending and ascending aorta, closure of ventricular septal defect and reconstruction of the right ventricular to pulmonary artery continuity using a valved conduit.
  
  
  RESULTS
  One (12.5%) patient died from sepsis and hepato-renal failure 18 days after surgery. Seven (87.5%) patients were followed up for 2.0-11.7 years (median 2.6 years). No patient died after the discharge from hospital. In 4 patients 1-3 reinterventions were required 0.6-10.0 years after repair. Reoperations were performed for conduit obstruction in 2 patients, aortic regurgitation in 2 patients, right pulmonary artery stenosis in 2 patients and airway obstruction in 1 patient. In 2 patients concommitant aortic valve and conduit replacement was required. Balloon angioplasty for aortic arch obstruction was necessary in 1 patient, and for bilateral pulmonary branch stenosis in 1 patient. Five (28.6%) surviving patients are in NYHA class I and 2 (71.4%) patients are in NYHA class II.
  
  
  CONCLUSIONS
  Primary repair of persistent truncus arteriosus with interrupted aortic arch can be done with low mortality and good mid-term results. Aortic arch reconstruction in isolated low-flow perfusion of the head and the heart influences favourably the postoperative recovery. The main postoperative problems are associated with conduit obstruction and aortic insufficiency.
authors.affiliation: Kardiocentrum, University Hospital Motol, V Uvalu 84, 150 06 Prague 5, Czech Republic. tomas.tlaskal@lfmotol.cuni.cz
authors.forename: Tomas
authors.initials: T
authors.lastname: Tlaskal
authors.forename: Bohumil
authors.initials: B
authors.lastname: Hucin
authors.forename: Vladimir
authors.initials: V
authors.lastname: Kucera
authors.forename: Pavel
authors.initials: P
authors.lastname: Vojtovic
authors.forename: Roman
authors.initials: R
authors.lastname: Gebauer
authors.forename: Vaclav
authors.initials: V
authors.lastname: Chaloupecky
authors.forename: Jan
authors.initials: J
authors.lastname: Skovranek
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery*; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery*; D006324:Heart Arrest, Induced; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010477:Perfusion / Q000379:methods; D012086:Reoperation; D016896:Treatment Outcome; D014339:Truncus Arteriosus, Persistent / Q000601:surgery*