Persistent truncus arteriosus repaired beyond infancy

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• 作者：Sachin Talwar (1) (2)
  Rachit Saxena (1)
  Shiv Kumar Choudhary (1)
  Anita Saxena (1)
  Shyam Sunder Kothari (1)
  Rajnish Juneja (1)
  Balram Airan (1)
  
• 关键词：Truncus arteriosus ; Pulmonary hypertension ; Congenital heart disease
• 刊名：Indian Journal of Thoracic and Cardiovascular Surgery
• 出版年：2012
• 出版时间：September 2012
• 年：2012
• 卷：28
• 期：3
• 页码：171-176
• 全文大小：117KB
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  2. Williams RL, Sommerville R. Truncus arteriosus. In: Garson A, Bricker JT, McNamara DG, editors. The Science and Practice of Pediatric Cardiology. Philadelphia: Lea and Febiger; 1990. p. 1127-3.
  3. Keith JD. Prevalence, incidence and epidemiology. In: Keith JD, Rowe RD, Vlad P, editors. Heart disease in infancy and childhood. New York: Macmillan; 1978. p. 3-3.
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  11. Marcelletti C, McGoon DC, Mair DD. The natural history of truncus arteriosus. Circulation. 1976;54:108-1. ss="external" href="http://dx.doi.org/10.1161/01.CIR.54.1.108">CrossRef
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  13. Rajasinghe HA, McElhinney DB, Mohan Reddy VM, Mora BN, Hanley FL. Long term follow up of truncus arteriosus repaired in infancy: A twenty yea<strong class="a-plus-plus">rstrong> experience. J Thorac Cardiovasc Surg. 1997;113:869-9. ss="external" href="http://dx.doi.org/10.1016/S0022-5223(97)70259-9">CrossRef
  14. Oka Y, Fujita T, Naito Y, et al. Truncus arteriosus in a thirty-one-year-old man with severe obstructive pulmonary vascular disease: a case report of successful surgical correction. Nihon Kyobu Geka Gakkai Zasshi. 1980;28:1322-.
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  17. Talwar S, Choudhary SK, Garg S, et al. Unidirectional valved patch closure of ventricular septal defects with severe pulmonary arterial hypertension. Interactive Cardio Vasc Thorac Surg. 2012;14:699-03. ss="external" href="http://dx.doi.org/10.1093/icvts/ivs044">CrossRef
  
• 作者单位：Sachin Talwar (1) (2)
  Rachit Saxena (1)
  Shiv Kumar Choudhary (1)
  Anita Saxena (1)
  Shyam Sunder Kothari (1)
  Rajnish Juneja (1)
  Balram Airan (1)
  
  1. Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India
  2. Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, 110029, India
  

文摘

Introduction Patients with untreated Persistent Truncus Arteriosus (PTA) usually do not survive or develop irreversible pulmonary vascular obstructive disease beyond infancy. The present study reports the anatomic and hemodynamic data, and results of surgery in patients undergoing surgical repair of PTA beyond 1?year of age. Patients and Methods Between January 2000 and March 2012, 9 patients aged 1?year or more underwent complete surgical repair of PTA. The median age was 3?years (range, 1?year to 12?years). Median weight was 9?kg (range, 4.7?kg to 30?kg). Seven patients had type I PTA and two patients had type II PTA. Five patients had mild and two patients had moderate truncal valve regurgitation. The mean pre-operative oxygen saturation was 87?% (SD?±-.07); mean indexed pulmonary vascular resistance was 9.1 units.m2 (range, 4.5 units.m2 to 12.3 units.m2). The right ventricular to pulmonary artery continuity was created by aortic homograft (n--), pulmonary homograft (n--) or valved bovine xenograft (n--). In one patient, the ventricular septal defect was closed with unidirectional valved patch. Follow up was complete for all patients. Results There were two in-hospital deaths: one each due to sepsis and intractable pulmonary hypertension. Mean follow up duration was 39?months (range, 3?months to 138?months). There were no late deaths. One patient underwent conduit replacement secondary to aneurysmal dilatation of the conduit with clots leading to conduit obstruction 1?month after the initial operation. None of the patients underwent an additional procedure for truncal regurgitation, which at follow up was trivial in 4 and mild in 3 patients. All patients had good biventricular function and pulmonary hypertension subsided in all. All survivors have systemic saturation in excess of 95?%. Conclusion A few naturally selected patients with PTA are still suitable candidates for surgical repair after infancy and the early and mid-term outcomes are satisfactory.