ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Our experiences with the surgical repair of truncus arteriosus: early and mid-term results
Ali Rıza Karacı1, Numan Ali Aydemir1, Ahmet Şaşmazel1, Buğra Harmandar1, Abdullah Erdem2, Nurgül Yurtsever3, Ahmet Çelebi2, Mehmet Salih Bilal4
1Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, 1Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
2Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Pediatrik Kardiyoloji Kliniği, İstanbul, Türkiye
3Dr. Siyami Ersek Göğüs Kalp Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
4Medicana Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2012.041
Background: This study aims to evaluate early and midterm results of the patients who were operated for truncus arteriosus (TA).

Methods: Between January 2003 and April 2010, 19 patients (16 males, 3 females; mean age 76±45 days; range 11 to 174 days) who underwent surgery due to TA in our clinic were included. The mean weight of the patients was 3.5±1.8 kg (range 2.7-4.3 kg). Six patients (32%) were operated in neonatal period, while 13 patients (68%) were operated in early childhood. According to Van Praagh classification, 11 patients (58%) were type A1, six patients (32%) were type A2 and one patient (5%) were type A3. One patient with type A4 had accompanying type B-interrupted aortic arcus. Truncal valve was tricuspid in 15 patients (79%) and tetracuspid in four patients (21%). All patients underwent single complete surgical repair of TA. Xenografts were used for right ventricular-pulmonary artery connection. The most frequently used extracardiac conduit was No 14 bovine jugular vein graft (contegra).

Results: Postoperative early mortality rate was 21.1% (n=4). The mean follow-up period was 21.9±20.8 months. Truncal valve regurgitation was mild in nine patients (60%) and moderate in one patient (7%). During follow-up period, six patients (40%) developed pulmonary artery stenosis. Four patients (66%) underwent balloon angioplasty, while stent was implanted in two patients (33%). Reintervention-free survival was 100% at one year, 69±13% at three years and 23±15% at five years.

Conclusion: Complete surgical repair of truncus arteriosus results in good outcomes in neonatal and early childhood. Reintervention may be required for the right ventricular out flow obstructions.

Keywords : Conduit; surgical repair; truncus arteriosus
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