Technique for the Repair of Truncus Arteriosus to Maintain Pulmonary Artery Architecture

A modified approach in the repair of type I and II truncus arteriosus to promote branch pulmonary arterial growth and limit early reoperation

“…Freedom from RVOT reoperation after the repair of TA is commonly reported between 30% and 55% at 5 years. 1 , 2 , 3 , 4 , 5 , 6 Using our modified approach, our group 10 , 11 , 12 and others 18 have consistently demonstrated a freedom from RVOT reoperation approaching 50% or better at 10 years. Although conduit failure after TA repair is inevitable, by using our modified approach, most children develop both mild to moderate RVOT stenosis and insufficiency by 2 years of age.…”

“…Since 1998, we have used a modified approach in the repair of TA where the branch PAs are kept in situ and a short aortic homograft used to establish right ventricular to PA continuity. 11 , 12 , 13 Using this approach exclusively, we have demonstrated excellent freedom from RVOT reoperation as well a limited need for surgical pulmonary arterioplasty during short- and intermediate-term follow-up. However, long-term outcomes, potential for branch PA growth, and risks for early reoperation using this modified approach have been left unexplored.…”