Repair of truncus arteriosus: choice of right ventricle outflow reconstruction.
OBJECTIVE
To find a better method of right ventricular-pulmonary artery (RV-PA) reconstruction in repairing truncus arteriosus (TA). BASIC STUDIES DESIGN: Retrospective clinical study, contrast study.


METHODS
Shanghai Children's Medical Center.


METHODS
23 patients with truncus arteriosus.


METHODS
To decrease the man-made interference, all of the exams during the follow-up period were carried out at our center.


METHODS
Hospital death, survival rate, the later outcomes during follow-up including the growth of pulmonary artery, the later heart function, and reintervention.


RESULTS
There were two early hospital deaths, with no deaths during follow-up. The overall survival rate was 91.30%. One patient underwent reintervention for RVOTO. In Group 1, the difference between the diameters of RV-PA anastomosis was statistically significant. The early diameter was 1.01 ± 0.26 cm, the later was 1.32 ± 0.45 cm, p = 0.019. The velocity of flow at the position of anastomosis and the orifice of RPA/LPA was acceptable. There was a significant difference between the growth ratio of the RV-PA anastomosis of two groups, with a p value of 0.048. The later ejection fraction was higher than the early one in both groups. There was no reintervention for truncal valve regurgitation.


CONCLUSIONS
The postoperative survival and follow-up results were satisfactory. A direct anastomosis of RV-PA continuity has the potential for RVOT growth and is associated with a low ratio of pulmonary artery and bifurcation obstruction. The myocardial function improved during follow-up period. IAA was a major risk factor associated with hospital death.
Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China. zwxumd@163.com
Zhi Wei
ZW
Xu
Jia
J
Shen
D000714:Anastomosis, Surgical; D001013:Aorta, Thoracic / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D013504:Cardiovascular Surgical Procedures; D002675:Child, Preschool; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007223:Infant; D011651:Pulmonary Artery / Q000601:surgery; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome; D014339:Truncus Arteriosus, Persistent / Q000601:surgery*; D014694:Ventricular Outflow Obstruction / Q000601:surgery*