Long-Term Follow-Up of Persistent Truncus Arteriosus: Kuwait Experience

Abstract

Objective: To evaluate the long-term results of patients in Kuwait who were operated for persistent truncus arteriosus (PTA). Subjects and Methods: The following data were collected for retrospective analysis from 24 medical records of consecutive patients with PTA in Kuwait between August 1993 and August 2009: demographics, morphology, management and outcome. Major associated abnormalities included interrupted aortic arch in 1 patient and abnormal coronary artery anatomy in 2. Results: Of the 24 patients, 16 underwent total intracardiac repair. The age at operation ranged from 15 days to 5 years (mean 166.19 ± 438.63 days) and weight ranged from 2.5 to 15 kg (mean 4.3 ± 3.01 kg). The right ventricle to pulmonary artery continuity was established with aortic homograft in 11, pulmonary homograft in 4 and by implantation of a Contegra conduit in 1 patient. Four patients had moderate truncal valve regurgitation requiring concomitant truncal valve repair. After a mean follow-up period of 81.81 ± 61.58 months (range 3–166) there was no death. Eight of the 16 (50%) patients underwent redo homograft operations. One patient who had concomitant truncal valve repair subsequently underwent aortic valve replacement. Conclusion: The data showed that complete repair of PTA in the neonatal and early infancy period was the treatment with the best potential for survival. The homograft remained one of the conduits of choice to establish continuity between the right ventricle and the pulmonary artery in spite of the high incidence of conduit redo operations.

Surgical Treatment of Common Arterial Trunk in Patients Beyond the First Year of Life

“…[3][4][5][6] Staging with early pulmonary artery banding followed by total correction at later ages is now primarily of historical interest. 1,2 Severe pulmonary vascular obstructive disease (PVOD) can occur early due to pulmonary overcirculation with risk of being inoperable. If left untreated, most patients die within the first year of life from severe cardiac failure.…”

“…The pathology accounts around 1% of all congenital cardiac defects. [1][2][3][4][5][6][7][8][9][10] In the current era, most patients are primarily repaired in the neonatal period. [3][4][5][6] Staging with early pulmonary artery banding followed by total correction at later ages is now primarily of historical interest.…”

Infantile Aortic Coarctation in an Adult with Heart Failure

“…However, its etiology is still unclear, and it has been postulated that, rather than a focal vascular stenosis, this anomaly might be part of a generalized vasculopathy. This hypothesis could be justified by its frequent association with other vascular anomalies, such as aortic aneurysms or intracranial malformations, and other congenital cardiovascular diseases, such as bicuspid aortic valves [5] , ventricular septal defects, patent ductus arteriosus, transposition of the great arteries, persistent truncus arteriosus [6] , atrioventricular canal defects, or left-sided obstructive heart defects, including hypoplastic left heart syndrome.…”

Late management of truncus arteriosus: 20 years of humanitarian experience

“…Late surgery is defined as beyond the usual criteria of operability of common arterial trunk as described in the literature. [9][10][11] We also described short-and mid-term follow-up of these children receiving late operations, and discussed the need for prior catheterisation in this population.…”

“…The purpose of this retrospective study was to establish whether children with “late-diagnosed common arterial trunk” can benefit from late surgery. Late surgery is defined as beyond the usual criteria of operability of common arterial trunk as described in the literature 9 11 We also described short- and mid-term follow-up of these children receiving late operations, and discussed the need for prior catheterisation in this population.…”