Survival After Single-Stage Repair of Truncus Arteriosus and Associated Defects

Overview

Journal Ann Thorac Surg

Publisher Elsevier

Specialties General Surgery
Pulmonary Medicine

Date 2023 Jul 6

PMID 37414385

Authors

Anmol Goyal

Jessica Knight

Mohammed Hasan

Hussain Rao

Amanda S Thomas

Amber Sarvestani

James St Louis

Lazaros Kochilas

Geetha Raghuveer

Affiliations

Soon will be listed here.

Abstract

Background: The goal of this study was to describe in-hospital and long-term mortality after single-stage repair of truncus arteriosus communis (TAC) and explore factors associated with these outcomes.

Methods: This was a cohort study of consecutive patients undergoing single-stage TAC repair between 1982 and 2011 reported to the Pediatric Cardiac Care Consortium registry. In-hospital mortality was obtained for the entire cohort from registry records. Long-term mortality was obtained for patients with available identifiers by matching with the National Death Index through 2020. Kaplan-Meier survival estimates were created for up to 30 years after discharge. Cox regression models estimated hazard ratios for the associations with potential risk factors.

Results: A total of 647 patients (51% male) underwent single-stage TAC repair at a median age of 18 days; 53% had type I TAC, 13% had interrupted aortic arch, and 10% underwent concomitant truncal valve surgery. Of these, 486 (75%) patients survived to hospital discharge. After discharge, 215 patients had identifiers for tracking long-term outcomes; 30-year survival was 78%. Concomitant truncal valve surgery at the index procedure was associated with increased in-hospital and 30-year mortality. Concomitant interrupted aortic arch repair was not associated with increased in-hospital or 30-year mortality.

Conclusions: Concomitant truncal valve surgery but not interrupted aortic arch was associated with higher in-hospital and long-term mortality. Careful consideration of the need and timing for truncal valve intervention may improve TAC outcomes.

Citing Articles

Management Strategies for Truncus Arteriosus: A Comparative Analysis of Staged vs. Primary Repair.

Kobayashi Y, Sano S, Narumiya Y, Kimura A, Suzuki E, Kasahara S Pediatr Cardiol. 2025; .

PMID: 39883183 DOI: 10.1007/s00246-025-03790-z.

Long-term Outcomes After Interrupted Aortic Arch Repair.

Miller J, Velani R, Miller W, Thomas A, Shaw F, Kochilas L Ann Thorac Surg. 2024; 118(2):469-477.

PMID: 38360344 PMC: 11269040. DOI: 10.1016/j.athoracsur.2024.02.009.

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