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OBJECTIVE The objective of this study was to identify patient and hospitalization characteristics associated with in-hospital mortality in infants with truncus arteriosus. METHODS We conducted a retrospective analysis of a large administrative database, the National Inpatient Sample data set of the Healthcare Cost and Utilization Project for the years 2002 to 2017. We also sought to evaluate the resource utilization in the subgroup of subjects with truncus arteriosus and 22q11.2 deletion syndrome. Neonates with truncus arteriosus were identified by ICD-9 and ICD-10 codes. Hospital and patient factors associated with inpatient mortality were analyzed. RESULTS Overall, 3009 neonates met inclusion criteria; a total of 326 patients died during the hospitalization (10.8%). Extracorporeal membrane oxygenation utilization was 7.1%. Univariate and multivariate logistic regression analyses were used to identify risk factors for in-hospital mortality. Significant risk factors for mortality were prematurity (adjusted odds ratio [aOR] = 2.43; 95% confidence interval [CI]: 1.40-4.22; P = .002), diagnosis of stroke (aOR = 26.2; 95% CI: 10.1-68.1; P

Background A complex and rare form of persistent truncus arteriosus needs careful attention when choosing the optimal strategy for repair. Aim of the study We herein describe our surgical strategy of a small infant having this malformation concomitantly with right aortic arch, unusual pulmonary artery branching and a left superior vena cava. Methods The patient underwent initially bilateral pulmonary arterial banding followed by the Rastelli type definitive repair. The pulmonary arteries were unified in front of the left superior vena cava, and the right ventricular outflow tract was readily reconstructed. Results The patient is doing well with an excellent hemodynamic status. Conclusions We considered the two-stage approach was sensible in this particular patient.

A two-stage surgical repair of a one-month-old infant with truncus arteriosus with unilateral absence of a proximal pulmonary artery (PA) with a closed ipsilateral ductus arteriosus was successfully performed. In the first palliation, translocation of the discontinuous, closed, and undeveloped PA to the adjacent area of the other PA was useful for making a pulmonary arterial confluence at timing of the subsequent radical operation.(J Card Surg 2010;25:90-92)

Objective: This study aims to analyze long-term results after correction of type I and type II truncus arteriosus in older patients operated in one institution over five years. Methods: Between 2006 and 2010, 12 patients, median age 4 years, underwent repair of truncus arteriosus. Repair with reconstruction of the right ventricular to pulmonary artery continuity was performed using a valved conduit in 12 patients. Results: There was no early mortality. All patients are alive with their original conduit 0.6 to 5 years after correction. No patients required reoperations for conduit dysfunction. Recent clinical examination was undertaken in all patients and they are in good condition. Conclusions: Though mean age at operation was higher in this study than published results, the operation should be performed if the pulmonary vascular resistance is under 8 units.m2 before operation.

Severe truncal valve stenosis, due to dysplastic valve, may be found in a small number of patients with truncus arteriosus. Its presence complicates the surgical management of this anomaly due to lack of optimal therapeutic options and associated ventricular dysfunction. We report a case of truncal root replacement using a homograft for the management of such condition, and review the literature related to its management and outcome.

Truncus arteriosus (TA) represents 1% to 3% of congenital heart malformations and carries a high mortality if untreated of approximately 85% at 1 year, with almost half the deaths occurring during the first month of life. Significant truncal valve regurgitation (TVR) can be present in up to 50% of cases and reduces survival if persistent after surgical correction. Repair of truncal valves is a promising approach since growth potential and hemodynamics are maintained. Nevertheless this remains a technical challenge and as much as 50% of these valves still need to be replaced at the time of primary repair. Cryopreserved aortic homografts used as aortic root substitutes have provided preservation of excellent hemodynamic conditions as well as prevention of infectious and thromboembolic complications of prosthetic valves. Even if they present structural deterioration with time, they represent an attractive alternative to prosthetic valves in infants and children who would anyhow need reoperation because of the outgrowth of valvular or conduit substitutes.

Since September, 1985, 20 patients have undergone implantation of a homograft valve in the pulmonary position (16 pulmonary, 4 aortic). There were 11 primary operations and 9 reoperations. In 7 of 11 primary operations the homograft valve was utilized as a composite conduit with a short Dacron extension. In four of five reoperations for a failed porcine valved conduit, a composite homograft conduit was used. Four patients underwent implantation of a free homograft in a previously repaired right ventricular outflow tract (RVOT). Age ranged from 15 days to 22 years. There was one operative death (5%), a seven-week-old infant with truncus arteriosus. Long-term follow-up ranges from 1 to 30 months. Clinical performance has been satisfactory in 18 of 19 patients. One patient undergoing free implantation of a pulmonary valve in the RVOT required replacement at 18 months with a porcine valve. In this patient, pulmonary insufficiency was caused by distortion of the annulus secondary to dilatation and pulmonary hypertension. Nine of 18 survivors do not require medication. Eleven of 18 have trivial to mild pulmonary insufficiency murmurs without symptomatology. The homograft valve is extremely useful in reconstruction of the right heart, however, early insufficiency murmurs have been noted. Distortion of the valve annulus may contribute to the early onset of a benign insufficiency murmur. Residual distal obstruction or pulmonary hypertension may be a contraindication to the use of a free homograft in the orthotopic position.