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Ann Thorac Surg 1991;52:780-786
© 1991 The Society of Thoracic Surgeons

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Articles

Repair of truncus arteriosus in infancy

Division of Cardiothoracic Surgery, Department of Surgery, and Department of Pediatric Cardiology, University of California, Los Angeles, Los Angeles, California USA

^_* Address reprint requests to Dr Laks, Division of Cardiothoracic Surgery, UCLA Medical Center CHS 62-151, 10833 LeConte Ave, Los Angeles, CA 90024.

Improvements in myocardial protection, surgical technique, and postoperative care have decreased operative mortality for neonatal repair of truncus arteriosus. Primary repair of truncus arteriosus in infancy without prior pulmonary artery banding is currently the preferred approach. During the period from 1982 to December 1990, 32 patients under the age of 12 months underwent surgical correction of truncus arteriosus at UCLA. The average age was 3.5 months (range, 12 days to 12 months). Three patients had interrupted aortic arch. Early mortality for the entire group was 15.6% ( [equation]); for those older than 1 month early mortality was 7% ( [equation]). In the past 4 years, early mortality has decreased to 8.3% ( [equation]); both of these patients had interrupted aortic arch. Excluding patients with interrupted aortic arch, there were no early deaths in the last 22 patients (1986 to 1990). Late mortality overall was 7.4% ( [equation]). In a mean follow-up of 73 months (range, 40 to 110 months), 71% ( [equation]) of the survivors with Dacron porcine-valved conduits required conduit replacement secondary to obstruction. In a mean follow-up of 36 months (range, 1 to 89 months), only 14% ( [equation]) of the patients with homografts required replacement secondary to obstruction.

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