Common arterial trunk: review of surgical strategies and future research

Siena, Paolo de; Ghorbel, Mohamed; Chen, Qiang; Yim, Deana; Caputo, Massimo

doi:10.1586/erc.11.170

Cited by 19 publications

(11 citation statements)

References 54 publications

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“…In contrast with previous studies based on early CAT operations, 11,13 in our more recent series, we found that surgical repair of CAT without a valved conduit was not associated with an increased risk of mortality. As in previous studies, we also found that coronary anomalies [1][2][3][4]8 and CAT with interrupted aortic arch [5][6][7][8] were independent risk factors for mortality.…”

Section: Mortalitysupporting

confidence: 88%

“…Risk factors for mortality related to common arterial trunk (CAT) include coronary anomalies leading to ostial or luminal coronary narrowing or stenosis, [1][2][3][4] truncal valve dysfunction, 5,6 and interrupted aortic arch [5][6][7] among the most frequently reported. In addition, low weight at surgery 8,9 and high pulmonary vascular resistance are also associated with a greater risk of mortality.…”

Section: Perspectivementioning

confidence: 99%

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Outcomes after common arterial trunk repair: Impact of the surgical technique

Derridj¹,

Villemain²,

Khoshnood³

et al. 2021

The Journal of Thoracic and Cardiovascular Surgery

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Objectives: We compared the risk of mortality and reintervention after common arterial trunk (CAT) repair for different surgical techniques, in particular the reconstruction of the right ventricle outflow tract with left atrial appendage (LAA) without a monocusp. Methods:The study population comprised 125 patients with repaired CAT who were followed-up at our institution between 2000 and 2018. Statistical analysis included Cox proportional hazard models.Results: Median follow-up was 10.6 years. The 10-year survival rate was 88.2% (95% confidence interval [CI], 80.6-92.4) with the poorest outcome for CAT type IV (64.3%; 95% CI, 36.8-82.3; P<.01). In multivariable analysis, coronary anomalies (hazard ratio [HR],], P<.001) and CAT with interrupted aortic arch (HR, 6.50 [2.10-20.16], P ¼ .001) were substantial and independent risk factors for mortality. Initial repair with LAA was not associated with an increased risk of mortality (HR, 0.37 [0.11-1.24], P ¼ .11). The median age at reintervention was 3.6 years [7.3 days-13.1 years]. At 10 years, freedom from reintervention was greater in the group with LAA repair compared with the valved conduit group, 73.3% (95% CI, 41.3-89.4) versus 17.2% (95% CI, 9.2-27.4) (P<.001), respectively. Using a valved conduit for repair (HR,.39], P < .001), truncal valve insufficiency (HR,], P < .001) and DiGeorge syndrome (HR, 2.01 [1.15-3.51], P ¼ .01) were independent and clinically important risk factors for reintervention.Conclusions: For the repair of CAT, the LAA technique for right ventricle outflow tract reconstruction was associated with comparable survival and greater freedom from reintervention than the use of a valved conduit. (

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Section: Mortalitysupporting

confidence: 88%

Section: Perspectivementioning

confidence: 99%

Outcomes after common arterial trunk repair: Impact of the surgical technique

Derridj¹,

Villemain²,

Khoshnood³

et al. 2021

The Journal of Thoracic and Cardiovascular Surgery

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“…4 SV heart defects can be divided into four types according to the morphological structure: Type A, the left ventricular main chamber is dominant; Type B, the right ventricular main chamber is dominant; Type C, the ventricular septum is absent, and the left and right ventricular structures constitute the ventricular cavity; and Type D, indeterminate. 5 Unlike echocardiography, three-dimensional ultrasound can visually display the internal structure of the heart, thus improving the accuracy of preoperative diagnosis, and is of great significance in the selection of surgical methods and the assessment of prognosis. 6 We reviewed literature reports of SV heart defect cases involving patients over 13 years of age without surgical intervention and summarized the common characteristics that were correlated to the long-term survival of the patients (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Long-term survival of patients with unoperated single ventricle heart : case reports and literature review

Zhao¹,

Guo²,

Sun³

et al. 2021

Preprint

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A single ventricle (SV) heart defect is a rare complex congenital cardiac malformation. We followed up the four adult patients who had SV since birth without surgical intervention and they had a good prognosis.The common ultrasound characteristics of four long-term SV survivors were investigated by reviewing their medical records and the literature, and the current treatment methods for SV patients were also reviewed. In our opinion,such patients with balanced hemodynamic condition should be followed and treated conservatively. This report aims to improve the prognosis as well as quality of life of SV patients.

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“…It is a rare lesion, accounting for 0.21-0.34% of congenital heart disease with an incidence of 0.03-0.05 cases per 1000 live births(2). Prior to availability of operative correction, children with TA demonstrated 80% mortality in the first year of life(3).…”

Section: Introductionmentioning

confidence: 99%

Morbidity in children and adolescents after surgical correction of truncus arteriosus communis

O’Byrne

Mercer‐Rosa

Zhao

et al. 2013

American Heart Journal

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Background Studies of outcome following operative correction of truncus arteriosus communis (TA) have focused on mortality and rates of re-intervention. We sought to investigate the clinical status of children and adolescents with surgically corrected TA. Methods and Results A cross-sectional study of subjects with TA was performed. Subjects underwent concurrent genetic testing, electrocardiogram, cardiac magnetic resonance imaging, cardiopulmonary exercise testing, and completed questionnaires assessing health status and health-related quality of life. Review of their medical history provided retrospective information on cardiac re-intervention and utilization of medical care. Twenty-five subjects with a median age of 11.8 (8.1-18.99) years were enrolled. The prevalence of 22q11.2 deletion was 32%. Incidence of hospitalization, cardiac re-intervention, and non-cardiac operations was highest in the first year of life. Combined catheter-based and operative re-intervention rates were 52% on the conduit and 56% on the pulmonary arteries. Right ventricular ejection fraction and end diastolic volume were normal. Moderate or greater truncal valve insufficiency was seen in 11% of subject, and truncal valve replacement occurred in 8% of subjects. Maximal oxygen consumption (p=0002), maximal work (p<0.0001), and forced vital capacity (p<0.0001) were all lower than normal for age and sex. Physical health status and health-related quality of life were both severely diminished. Conclusion Patients with TA demonstrate significant co-morbid disease throughout childhood, significant burden of operative and catheter-based re-intervention, and deficits in exercise performance, functional status, and health-related quality of life.

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Common arterial trunk: review of surgical strategies and future research

Cited by 19 publications

References 54 publications

Outcomes after common arterial trunk repair: Impact of the surgical technique

Outcomes after common arterial trunk repair: Impact of the surgical technique

Long-term survival of patients with unoperated single ventricle heart : case reports and literature review

Morbidity in children and adolescents after surgical correction of truncus arteriosus communis

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