Improving early and intermediate results of truncus arteriosus repair: A new technique of truncal valve repair

Background. Despite improved surgical results for truncus arteriosus, overa ll mortality rates, remain higher than those reported for other complex con genital heart diseases, especially with truncal valve regurgitation or an i nterrupted aortic arch. Methods. Seventeen patients had complete repair of the truncus arteriosus a t the Cleveland Clinic Foundation between August 1993 and June 1997. The ag e at operation ranged from 2 days to 4.5 years. Associated abnormalities in cluded interrupted aortic arch in 3 patients and abnormal coronary artery a natomy in 3. Four patients had more than moderate truncal valve insufficien cy requiring concomitant truncal valve repair. Results. There were no early deaths and only one late death at a mean follow-up of 24 months. The death occurred 3 months postoperatively and resulted from refractory pulmonary v ascular obstructive disease in a patient who was referred at 1 year of age. Reoperation was required in 4 patients. Conclusions. Even in the presence of associated anomalies complete repair w as performed with a low mortality rate. Truncal valve repair can be perform ed safely in the neonate with good results.