Repair of persistent truncus arteriosus with interrupted aortic arch

Objective: The aim of our study was to analyse experience with repair of truncus arteriosus with interrupted aortic arch. Methods: Between 1993 and 2004, eight consecutive patients underwent repair of truncus arteriosus with interrupted aortic arch. The median age was 6.5 days (range 1—85 days) and median weight was 3.2 kg (range 2.6—4.8 kg). Five patients had type A and 3 patients had type B aortic arch interruption. The repair was performed in deep hypothermia with circulatory arrest in 4 patients and isolated selective low-flow perfusion of the head and the heart in the last 4 patients. The repair consisted in aortic arch reconstruction by direct anastomosis between descending and ascending aorta, closure of ventricular septal defect and reconstruction of the right ventricular to pulmonary artery continuity using a valved conduit. Results: One (12.5%) patient died from sepsis and hepato-renal failure 18 days after surgery. Seven (87.5%) patients were followed up for 2.0—11.7 years (median2.6years).Nopatientdiedafterthedischargefromhospital.In4patients1—3reinterventionswererequired0.6—10.0yearsafterrepair. Reoperations wereperformedfor conduitobstructionin2 patients, aorticregurgitationin2 patients, rightpulmonaryartery stenosisin 2 patients andairwayobstructionin1 patient.In2 patientsconcommitantaorticvalveand conduitreplacementwasrequired.Balloonangioplastyfor aortic arch obstruction was necessary in 1 patient, and for bilateral pulmonary branch stenosis in 1 patient. Five (28.6%) surviving patients are in NYHA class I and 2 (71.4%) patients are in NYHA class II. Conclusions: Primary repair of persistent truncus arteriosus with interrupted aortic arch can be done with low mortality and good mid-term results. Aortic arch reconstruction in isolated low-flow perfusion of the head and the heart influences favourably the postoperative recovery. The main postoperative problems are associated with conduit obstruction and aortic insufficiency. # 2005 Elsevier B.V. All rights reserved.