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Outcome of truncus arteriosus repair: 20 years of single-center experience comparing early versus late surgical repair

Part of: Cardiac Morphology

Published online by Cambridge University Press:  20 October 2021

Abdah Hrfi Open the ORCID record for Abdah Hrfi [Opens in a new window] ,
Muna Ismail ,
Mohammed H. A. Mohammed ,
Hussam K. Hamadah Open the ORCID record for Hussam K. Hamadah [Opens in a new window] ,
Fahad Alhabshan Open the ORCID record for Fahad Alhabshan [Opens in a new window] ,
Riyadh Abu-Sulaiman  and
Mohamed Salim Kabbani
Abdah Hrfi
Affiliation:
Department of Cardiac Science, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Department of Pediatric Cardiology, Prince Sultan Cardiac Center, Qassim, Saudi Arabia
Muna Ismail
Affiliation:
Department of Cardiac Science, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Mohammed H. A. Mohammed
Affiliation:
Department of Cardiac Science, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Hussam K. Hamadah
Affiliation:
Department of Cardiac Science, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Fahad Alhabshan
Affiliation:
Department of Cardiac Science, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Riyadh Abu-Sulaiman
Affiliation:
Department of Cardiac Science, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Mohamed Salim Kabbani*
Affiliation:
Department of Cardiac Science, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
*
Author for correspondence: Dr M. S. Kabbani, Pediatric Cardiac ICU, MC 1423, King Abdulaziz Medical City, P.O. BOX 22490, Riyadh11426, Saudi Arabia. Tel: +966 118011111x13621; Fax: +966 118011111x16773. E-mail: kabbanim@ngha.med.sa
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Abstract

Background:

Truncus arteriosus is a rare CHD. Neonatal and early infancy repair is recommended though some cases may present late. The aim of our study is to investigate the current results of truncus arteriosus repair and to analyse the differences in outcome and reintervention need between early versus late truncus arteriosus surgical repair.

Material and methods:

In this cohort study, we reviewed all children who underwent truncus arteriosus repair from 2001 till 2021. We divided patients into two groups; early repair group including patients repaired at age less than 3 months and late repair group including patients who had repair at 3 months of age and later. We compared both groups for outcome variables.

Results:

Sixty-four children had truncus arteriosus repair including 48(75%) patients in early repair and 16(25%) patients in late repair groups. Peri-operative course was comparable between both groups. Post-surgery, we observed pulmonary hypertension in 6(12%) patients in early repair group comparing with 11(69%) patients in late repair group (p = 0.0001). In the last follow-up visit, pulmonary hypertension resolved in all early repair group patients while 6(37.5%) patients in late repair group continued to have pulmonary hypertension (p = 0.0001). Twenty-three(36%) patients required reintervention including 22(48%) in early repair group versus 1(6%) in late repair group (p = 0.007).

Conclusion:

In general, the outcome of early truncus arteriosus repair is excellent with resolution of pulmonary hypertension following early repair. Late repair caries higher risk of persistent pulmonary hypertension (37.5%). About one-third of the patients who had truncus arteriosus repair will require re-intervention within 38±38.4 months after initial surgery.

Keywords

Truncus arteriosuslate repairoutcomeconduit replacementpulmonary hypertension
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 8 , August 2022 , pp. 1289 - 1295
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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