To determine whether the right ventricle outflow tract (RVOT) type of reconstruction is correlated to different outcomes in long term results in patients who survived after surgical repair of truncus arteriosus (TA).
We retrospectively reviewed the outcomes of 30 patients with TA who underwent successful surgical repair in our center between 1994–2017. We analyzed late results according to the type of RVOT repair.
Among 30 survivors after TA repair, 6 (20%) were affected by DiGeorge syndrome. The RVOT reconstruction was achieved by means of a conduit (Contegra or Homograft) in 53.6%. In the remaining group of patients, a direct right ventricle-pulmonary artery anastomosis ± interposition of left atrial appendage (LAA) was performed. At a median follow-up time of 12 years (range 4 months-23 years, 93% complete), 6 patients (3 affected by DiGeorge syndrome) died late. Between RVOT groups, there was no difference in terms of late mortality; however, the use of a conduit was significantly associated with a higher risk for reoperation (p 0.021; OR 8.80, 1.35–57.4, Figure 1).
Post surgical history of patients with TA is characterized by a higher incidence of late adverse events when RVOT is reconstructed by means of a conduit. Reconstruction of the RVOT with a direct anastomosis and/or left atrial appendage interposition reduces effectively the need for reoperation in long term.
1UOC Cardiochirurgia Pediatrica e Cardiopatie Congenite, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari Padova
2Laboratorio PCare, Fondazione Istituto di Ricerca Pediatrica “Città della Speranza” Padova
3UOC Cardiologia Pediatrica, Dipartimento Strutturale Aziendale Salute della Donna e del Bambino Padova