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Impact of truncal valve surgery on the outcomes of the truncus arteriosus repair.
- Source :
-
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2018 Sep 01; Vol. 54 (3), pp. 524-531. - Publication Year :
- 2018
-
Abstract
- Objectives: Preoperative moderate or greater truncal valve (TV) insufficiency is one of the most important factors influencing mortality in children with truncus arteriosus. We therefore sought to determine the impact of TV insufficiency and concomitant TV surgery on children who underwent truncus arteriosus repair at a single institution.<br />Methods: We reviewed 180 patients who underwent truncus arteriosus repair between 1979 and 2016. Preoperative echocardiography demonstrated TV insufficiency in 80 patients (mild: 33.9%, 61/180; moderate: 9.4%, 17/180 and severe: 1.1%, 2/180).<br />Results: Twenty-one patients had concomitant TV surgery with an early mortality of 19% (4/21) and overall survival of 70.8 ± 10.1% at 25 years. There were 60 neonates, 11 of whom had concomitant TV surgery with an early mortality of 27% (3/11) and overall survival of 62.3 ± 15.0% at 20 years. Concomitant TV repair (P = 0.5) was not a risk factor for death. TV reoperation was common in those who had concomitant TV surgery, with freedom from reoperation of 19.2 ± 14.9% at 20 years. In the remaining 159 patients, 14 required subsequent TV surgery, and the freedom from TV surgery was 84.0 ± 4.6% at 20 years. At a median follow-up of 18.5 years, TV insufficiency was none or trivial in 79.6% (109/137) and mild or less in 98.5% (135/137) of patients.<br />Conclusions: Most patients with mild TV insufficiency are free from TV surgery up to 25 years. The durability of TV repair is poor. Most patients with moderate or greater TV insufficiency and a quadricuspid TV will require TV surgery.
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Heart Valves surgery
Humans
Infant
Reoperation
Retrospective Studies
Treatment Outcome
Truncus Arteriosus diagnostic imaging
Truncus Arteriosus, Persistent diagnostic imaging
Young Adult
Cardiac Surgical Procedures adverse effects
Cardiac Surgical Procedures methods
Cardiac Surgical Procedures mortality
Cardiac Surgical Procedures statistics & numerical data
Truncus Arteriosus surgery
Truncus Arteriosus, Persistent surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1873-734X
- Volume :
- 54
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29528381
- Full Text :
- https://doi.org/10.1093/ejcts/ezy080