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Repair of Truncus Arteriosus: Choice of Right Ventricle Outflow Reconstruction
Author(s) -
Xu Zhi Wei,
Shen Jia
Publication year - 2010
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2010.01125.x
Subject(s) - medicine , truncus arteriosus , anastomosis , cardiology , pulmonary artery , ventricle , ejection fraction , ventricular outflow tract , surgery , pulmonary valve , truncus , survival rate , tetralogy of fallot , heart disease , heart failure
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. Clinical setting: Shanghai Children's Medical Center. Participants: 23 patients with truncus arteriosus. Intervention: To decrease the man‐made interference, all of the exams during the follow‐up period were carried out at our center. Main outcome measurements: 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 . (J Card Surg 2010;25:724‐729)