Repair of truncus arteriosus beyond optimal timing of surgery

AIM:To review the experience and outcomes of one-stage repair of truncus arteriosus(TA) in patients who were beyond the optimal time for surgical repair.METHODS:From June 2008 to July 2010,14 patients(6 males and 8 females) underwent one-stage repair of TA with pulmonary hypertension under hypothermia cardiopulmonary bypass.Mean age of the patients was(4±5) years(range 0.6-18 years).Patients were much older than the generally accepted optimal age for surgical repair.Mean pulmonary artery pressure ranged from 56 to 101 mmHg and right ventricle-pulmonary artery continuity was reconstructed in six patients with a pulmonary homograft conduit and in eight patients using a bovine jugular conduit.RESULTS:There was one in-hospital death and one case requiring reexploration for postoperative bleeding.During a mean follow-up of(1.6±0.7) years,no late deaths occurred and heart functions improved in the 13 survivors.CONCLUSION:Satisfactory outcomes are obtained in patients with TA who have passed the optimal age for surgical repair,using either a pulmonary homograft or a bovine jugular conduit.Long-term follow-up is needed for possible conduit failure or dysfunction.