OBJECTIVES: Truncal valve regurgitation remains a short- and long-term risk factor for patients with truncus arteriosus. There are limited data available on techniques and outcomes of truncal valve repair (TVR). The aim of this study was to report our experience with TVR in patients of all ages. METHODS: From 1997 to 2012, 36 patients (13 neonates, 30 children and 3 adults) underwent TVR for significant regurgitation. RESULTS: There were 3 early deaths (8%), all of which were in neonates. Twenty-two patients had a quadricuspid, 13 a tricuspid and 1 a bicuspid truncal valve before repair. Valve repair improved regurgitation in 31 of 36 repairs. The median regurgitation decreased from moderate-severe to mild (P < 0.001). During a mean follow-up of 38.3 ± 44.9 months (range 1 month-15 years), there was 1 late death, 16 patients required reoperation on the truncal valve and 1 required a second reoperation. Freedom from reoperation was 91.4 ± 4.8% at 1 year, 55.0 ± 10.4% at 5 and 22.9 ± 12.2% at 10 years. A quadricuspid valve after repair tended to worsen freedom from reoperation (P = 0.15), and tricuspidization tended to improve freedom from reoperation (P = 0.19). Neonatal repair (hazards ratio (HR) 4.1, P = 0.03) and leaflet thinning (HR 22.5, P = 0.002) were independent predictors of reoperation. CONCLUSIONS: Valve repair for truncal valve regurgitation is feasible, with good results. Surgical creation of a tricuspid truncal valve seems to provide the best outcomes in this challenging population.
OBJECTIVES:Truncal valve regurgitation remains a short- and long-term risk factor for patients with truncus arteriosus. There are limited data available on techniques and outcomes of truncal valve repair (TVR). The aim of this study was to report our experience with TVR in patients of all ages. METHODS: From 1997 to 2012, 36 patients (13 neonates, 30 children and 3 adults) underwent TVR for significant regurgitation. RESULTS: There were 3 early deaths (8%), all of which were in neonates. Twenty-two patients had a quadricuspid, 13 a tricuspid and 1 a bicuspid truncal valve before repair. Valve repair improved regurgitation in 31 of 36 repairs. The median regurgitation decreased from moderate-severe to mild (P < 0.001). During a mean follow-up of 38.3 ± 44.9 months (range 1 month-15 years), there was 1 late death, 16 patients required reoperation on the truncal valve and 1 required a second reoperation. Freedom from reoperation was 91.4 ± 4.8% at 1 year, 55.0 ± 10.4% at 5 and 22.9 ± 12.2% at 10 years. A quadricuspid valve after repair tended to worsen freedom from reoperation (P = 0.15), and tricuspidization tended to improve freedom from reoperation (P = 0.19). Neonatal repair (hazards ratio (HR) 4.1, P = 0.03) and leaflet thinning (HR 22.5, P = 0.002) were independent predictors of reoperation. CONCLUSIONS: Valve repair for truncal valve regurgitation is feasible, with good results. Surgical creation of a tricuspid truncal valve seems to provide the best outcomes in this challenging population.
Authors: Adnan M Bakar; John M Costello; Peter Sassalos; Venu Amula; Jason R Buckley; Arthur J Smerling; Ilias Iliopoulos; Christine M Riley; Aimee Jennings; Katherine Cashen; Sukumar Suguna Narasimhulu; Keshava Murthy Narayana Gowda; Michael Wilhelm; Aditya Badheka; James E Slaven; Christopher W Mastropietro Journal: Pediatr Cardiol Date: 2020-07-03 Impact factor: 1.655
Authors: Qiuming Chen; Huawei Gao; Zhongdong Hua; Keming Yang; Jun Yan; Hao Zhang; Kai Ma; Sen Zhang; Lei Qi; Shoujun Li Journal: PLoS One Date: 2016-01-11 Impact factor: 3.240
Authors: Patrick O Myers; Christopher W Baird; Pedro J Del Nido; Frank A Pigula; Nora Lang; Gerald R Marx; Sitaram M Emani Journal: Front Surg Date: 2015-11-10
Authors: Laura Gellis; Geoffrey Binney; Laith Alshawabkeh; Minmin Lu; Michael J Landzberg; John E Mayer; Mary P Mullen; Anne Marie Valente; Lynn A Sleeper; David W Brown Journal: J Am Heart Assoc Date: 2020-11-09 Impact factor: 6.106