Truncus arteriosus repair: a 40-year multi-centre perspective

Abstract Objectives We sought to examine the long-term surgical outcomes of patients who underwent truncus arteriosus (TA) repair. Methods Between 1979 and 2018, 255 patients underwent TA repair at 3 Australian hospitals. Data were obtained by review of medical records from initial admission until last cardiology follow-up. Results Median age at repair was 44 days and median weight at repair was 3.5kg. Early mortality was 13.3% (34/255), and overall survival was 76.8 ± 2.9% at 20 years. Neonatal surgery and low operative weight were risk factors for early mortality. Most deaths (82.5%, 47/57) occurred within the first year following repair. The coronary artery anomaly and early reoperation were as risk factors for late mortality. A total of 175 patients have required at least 1 reoperation, with overall freedom of reoperation of 2.9 ± 1.5% at 20 years. Follow-up was 96% (191/198) complete for survivors. Median follow-up time was 16.4 years. At last follow-up, 190 patients were in NYHA Class I/II, while 1 patient was in Class III. Conclusion TA repair in the neonatal period still presents significant surgical challenges. Neonates with signs of over-circulation should be operated on promptly. Coronary artery anomaly is a risk factor for late mortality. Survival beyond the first year following repair is associated with excellent outcomes.