Early and mid term results of an alternative procedure to homografts in primary repair of Truncus Arteriosus Communis

  • Dr Pedro Curi-Curi, “Ignacio Chávez” National Cardiology Institute of Mexico, Mexico
  • Dr Samuel Ramirez-Marroquin, “Ignacio Chávez” National Cardiology Institute of Mexico, Mexico
  • Dr Jorge Cervantes, “Ignacio Chávez” National Cardiology Institute of Mexico, Mexico
  • Dr Mauricio Soule, “Ignacio Chávez” National Cardiology Institute of Mexico, Mexico
  • Dr Julio Erdmenger, “Ignacio Chávez” National Cardiology Institute of Mexico, Mexico
  • Dr Carlos Zabal, “Ignacio Chávez” National Cardiology Institute of Mexico, Mexico
  • Dr Juan Calderon-Colmenero, “Ignacio Chávez” National Cardiology Institute of Mexico

    • Objective. Early repair of truncus arteriosus communis (TAC) has become a standard practice in many centers. We report our experience on primary repair of TAC predominantly with the use of a pericardial valved Woven Dacron conduit as an alternative procedure to homografts, with a focus on early and midterm results.
    Methods. We studied 18 patients in a 6-year period, with a median age of 2.5 years that underwent primary repair of TAC. Cases with cardiogenic shock, complex associated cardiac lesions or adverse anatomy of the truncal valve were excluded. Collett and Edwards classification was type I , 12 (66%); type II, 5 (28%) and type III, 1 (6%). Right ventricular outflow tract was reconstructed in 15 cases (83.3%) with a pericardial valved Woven Dacron conduit.
    Results. The overall hospital mortality was 6%. At a mean follow-up of 28 months there were no deaths (5-year actuarial survival 94%). Of the 17 midterm survivors, 3 developed stenosis of the pericardial valved Woven Dacron conduit, but only one underwent interventional procedure. For the group of patients that received a pericardial valved Woven Dacron conduit, the freedom from reintervention in the mid term (5 years) was 76%.
    Conclusions. Truncus arteriosus communis repair with a pericardial valved Woven Dacron conduit can be performed with a very low perioperative mortality and satisfactory midterm morbidity, favorably compared with that reported for the use of homografts. Interventional cardiac catheterization may delay the time of reoperation for inevitable conduit replacement.