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1.
Vet Med Sci ; 9(3): 1031-1035, 2023 05.
Article in English | MEDLINE | ID: mdl-37029758

ABSTRACT

A 10-month-old female domestic shorthaired (DSH) cat was presented with peracute respiratory problems. Physical examination revealed dyspnoea, tachypnoea, cyanosis, weak pulse and bradycardia. Auscultation showed pulmonary crepitation and attenuated heart sounds and a pansystolic grade V/VI murmur. The electrocardiogram showed atrioventricular dissociation identified as third-degree sinoatrial block. X-rays showed increased density in the ventral and middle zones of the thorax and loss of definition of the cardiac silhouette and increased diffuse radiographic density of the entire abdomen. Echocardiography revealed dilatation of the right atrium and concentric biventricular hypertrophy. A type 1 persistent truncus arteriosus was diagnosed at necropsy. This is the first case report of this type of arrhythmia in a cat with persistent truncus arteriosus, and its relationship with the described congenital cardiac anomaly is discussed.


Subject(s)
Cat Diseases , Truncus Arteriosus, Persistent , Female , Cats , Animals , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus, Persistent/veterinary , Echocardiography , Electrocardiography , Diagnosis, Differential , Heart Block/diagnosis , Heart Block/veterinary , Cat Diseases/diagnostic imaging
2.
Article in English | MEDLINE | ID: mdl-35224899

ABSTRACT

Truncus arteriosus is a rare cardiac anomaly, accounting for less than 4% of all congenital lesions. It is the result of failed aorticopulmonary septation during the fifth week of gestation leading to a single arterial trunk overriding the interventricular septum, a single semilunar valve, and typically a large conotruncal ventricular septal defect. Several classifications exist, and it typically requires surgical repair in the neonatal period. We present a 5-day old female neonate who was diagnosed postnatally with type I truncus arteriosus in which the pulmonary arteries arose from a discrete pulmonary trunk that originated from the posterolateral aspect of the common arterial trunk. A successful repair was undertaken using a variant of the Barbero-Marcial technique.


Subject(s)
Heart Defects, Congenital , Heart Septal Defects, Ventricular , Truncus Arteriosus, Persistent , Aortic Valve , Female , Humans , Infant, Newborn , Truncus Arteriosus/surgery , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus, Persistent/surgery
3.
Braz J Cardiovasc Surg ; 37(1): 131-134, 2022 03 10.
Article in English | MEDLINE | ID: mdl-35072407

ABSTRACT

CLINICAL DATA: Patient diagnosed with common arterial trunk, submitted to pulmonary artery banding in another center and lost to clinical follow-up. Referred to our center at four years old, extremely cyanotic. Chest radiography: Cardiomegaly; attenuated peripheral vascular markings. Electrocardiography: Right ventricular hypertrophy. Echocardiography: Common arterial trunk, but it was not possible to analyze all the structures. Computed tomography angiography: Van Praagh type A4 common arterial trunk. Extremely hypoplastic right and left pulmonary arteries. DIAGNOSIS: Association of aortic arch interruption type A is uncommon and should be considered. OPERATION: Debanding of pulmonary arteries allowing for possible future complete repair.


Subject(s)
Heart Defects, Congenital , Truncus Arteriosus, Persistent , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Child, Preschool , Echocardiography , Humans , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Truncus Arteriosus, Persistent/diagnosis
4.
J Thorac Cardiovasc Surg ; 163(1): 224-236.e6, 2022 Jan.
Article in English | MEDLINE | ID: mdl-33726908

ABSTRACT

OBJECTIVE: In this study, we sought to identify independent risk factors for mortality and reintervention after early surgical correction of truncus arteriosus using a novel statistical method. METHODS: Patients undergoing neonatal/infant truncus arteriosus repair between January 1984 and December 2018 were reviewed retrospectively. An innovative statistical strategy was applied integrating competing risks analysis with modulated renewal for time-to-event modeling. RESULTS: A total of 204 patients were included in the study. Mortality occurred in 32 patients (15%). Smaller right ventricle to pulmonary artery conduit size and truncal valve insufficiency at birth were significantly associated with overall mortality (right ventricle to pulmonary artery conduit size: hazard ratio, 1.34; 95% confidence interval, 1.08-1.66, P = .008; truncal valve insufficiency: hazard ratio, 2.5; 95% confidence interval, 1.13-5.53, P = .024). truncal valve insufficiency at birth, truncal valve intervention at index repair, and number of cusps (4 vs 3) were associated with truncal valve reoperations (truncal valve insufficiency: hazard ratio, 2.38; 95%, confidence interval, 1.13-5.01, P = .02; cusp number: hazard ratio, 6.62; 95% confidence interval, 2.54-17.3, P < .001). Right ventricle to pulmonary artery conduit size 11 mm or less was associated with a higher risk of early catheter-based reintervention (hazard ratio, 1.54; 95% confidence interval, 1.04-2.28, P = .03) and reoperation (hazard ratio, 1.96; 95% confidence interval, 1.33-2.89, P = .001) on the right ventricle to pulmonary artery conduit. CONCLUSIONS: Smaller right ventricle to pulmonary artery conduit size and truncal valve insufficiency at birth were associated with overall mortality after truncus arteriosus repair. Quadricuspid truncal valve, the presence of truncal valve insufficiency at the time of diagnosis, and truncal valve intervention at index repair were associated with an increased risk of reoperation. The size of the right ventricle to pulmonary artery conduit at index surgery is the single most important factor for early reoperation and catheter-based reintervention on the conduit.


Subject(s)
Cardiovascular Surgical Procedures , Heart Valves , Heart Ventricles , Long Term Adverse Effects , Postoperative Complications , Reoperation , Risk Assessment , Truncus Arteriosus, Persistent/surgery , Adult , Cardiovascular Surgical Procedures/adverse effects , Cardiovascular Surgical Procedures/methods , Cardiovascular Surgical Procedures/mortality , Causality , Female , Heart Valves/abnormalities , Heart Valves/physiopathology , Heart Valves/surgery , Heart Ventricles/abnormalities , Heart Ventricles/physiopathology , Humans , Infant , Long Term Adverse Effects/diagnosis , Long Term Adverse Effects/etiology , Long Term Adverse Effects/mortality , Long Term Adverse Effects/surgery , Male , Mortality , Postoperative Complications/diagnosis , Postoperative Complications/mortality , Postoperative Complications/surgery , Pulmonary Artery/abnormalities , Pulmonary Artery/surgery , Reoperation/methods , Reoperation/standards , Reoperation/statistics & numerical data , Retrospective Studies , Risk Assessment/methods , Risk Assessment/statistics & numerical data , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus, Persistent/physiopathology , United States/epidemiology
6.
World J Pediatr Congenit Heart Surg ; 12(2): 286-290, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33684014

ABSTRACT

Van Praagh (VP) A3 variant of truncus arteriosus (or common arterial trunk) is defined by only one pulmonary artery (usually the right) originating from the common trunk, while the other lung is supplied either by collaterals or a pulmonary artery arising from the aortic arch. This report describes a staged approach to manage a VP-A3 variant truncus arteriosus with ductal origin of the left pulmonary artery (LPA), a hypoplastic right pulmonary artery, and cyanosis. Initially, the ductal portion of the proximal LPA was stented with a Resolute Onyx drug-eluting stent. The pulmonary arteries grew and at four months of age had an acceptable McGoon ratio and Nakata index. The patient then underwent repair which included unifocalization of the branch pulmonary arteries, closure of the ventricular septal defect, and placement of a right ventricle-to-pulmonary artery homograft conduit.


Subject(s)
Aorta, Thoracic/surgery , Cardiac Surgical Procedures/methods , Drug-Eluting Stents , Pulmonary Artery/surgery , Truncus Arteriosus, Persistent/surgery , Adult , Female , Humans , Infant, Newborn , Male , Pregnancy , Tomography, X-Ray Computed , Truncus Arteriosus, Persistent/diagnosis
7.
Cardiol Young ; 31(8): 1345-1347, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33597053

ABSTRACT

Anomalous origin of a single coronary artery arising from the innominate artery associated with coronary artery fistula and truncus arteriosus is extremely rare. We found this anomaly in a 16-month-old infant-girl who received Rastelli procedure during the operation. The three defects described above are rarely found together; indeed, such a case as ours may be the first reported in the literature.


Subject(s)
Coronary Vessel Anomalies , Fistula , Heart Defects, Congenital , Truncus Arteriosus, Persistent , Brachiocephalic Trunk/diagnostic imaging , Brachiocephalic Trunk/surgery , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/diagnosis , Coronary Vessel Anomalies/surgery , Coronary Vessels , Female , Heart Defects, Congenital/complications , Heart Defects, Congenital/diagnosis , Humans , Infant , Pulmonary Artery , Truncus Arteriosus , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus, Persistent/surgery
8.
J Thorac Cardiovasc Surg ; 162(4): 1205-1214.e2, 2021 10.
Article in English | MEDLINE | ID: mdl-33342576

ABSTRACT

OBJECTIVES: We compared the risk of mortality and reintervention after common arterial trunk (CAT) repair for different surgical techniques, in particular the reconstruction of the right ventricle outflow tract with left atrial appendage (LAA) without a monocusp. METHODS: The study population comprised 125 patients with repaired CAT who were followed-up at our institution between 2000 and 2018. Statistical analysis included Cox proportional hazard models. RESULTS: Median follow-up was 10.6 years. The 10-year survival rate was 88.2% (95% confidence interval [CI], 80.6-92.4) with the poorest outcome for CAT type IV (64.3%; 95% CI, 36.8-82.3; P < .01). In multivariable analysis, coronary anomalies (hazard ratio [HR], 11.63 [3.84-35.29], P < .001) and CAT with interrupted aortic arch (HR, 6.50 [2.10-20.16], P = .001) were substantial and independent risk factors for mortality. Initial repair with LAA was not associated with an increased risk of mortality (HR, 0.37 [0.11-1.24], P = .11). The median age at reintervention was 3.6 years [7.3 days-13.1 years]. At 10 years, freedom from reintervention was greater in the group with LAA repair compared with the valved conduit group, 73.3% (95% CI, 41.3-89.4) versus 17.2% (95% CI, 9.2-27.4) (P < .001), respectively. Using a valved conduit for repair (HR, 4.79 [2.45-9.39], P < .001), truncal valve insufficiency (HR, 2.92 [1.62-5.26], P < .001) and DiGeorge syndrome (HR, 2.01 [1.15-3.51], P = .01) were independent and clinically important risk factors for reintervention. CONCLUSIONS: For the repair of CAT, the LAA technique for right ventricle outflow tract reconstruction was associated with comparable survival and greater freedom from reintervention than the use of a valved conduit.


Subject(s)
Cardiovascular Surgical Procedures , Coronary Vessel Anomalies , Postoperative Complications , Reoperation , Truncus Arteriosus, Persistent/surgery , Atrial Appendage/diagnostic imaging , Atrial Appendage/surgery , Cardiovascular Surgical Procedures/adverse effects , Cardiovascular Surgical Procedures/instrumentation , Cardiovascular Surgical Procedures/methods , Child , Coronary Vessel Anomalies/epidemiology , Coronary Vessel Anomalies/surgery , France/epidemiology , Heart Ventricles/diagnostic imaging , Heart Ventricles/surgery , Humans , Infant, Newborn , Male , Mortality , Outcome and Process Assessment, Health Care , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/surgery , Reoperation/methods , Reoperation/statistics & numerical data , Risk Adjustment/methods , Risk Factors , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus, Persistent/mortality , Truncus Arteriosus, Persistent/physiopathology
9.
Ann Thorac Surg ; 112(6): 2005-2011, 2021 Dec.
Article in English | MEDLINE | ID: mdl-33217401

ABSTRACT

BACKGROUND: Truncus arteriosus is associated with coronary anomalies. We identified coronary artery lesions in patients undergoing repair of truncus arteriosus, defined the impact of lesions on mortality, and studied the effect of surgical intervention of coronary lesions. METHODS: A retrospective review identified 107 patients with truncus repair (1995-2019). Coronary lesions were categorized as ostial stenosis, intramural, juxtacommissural origin, and single coronary. Survival analysis characterized survival after truncus repair and studied the association of coronary lesions and mortality. RESULTS: Among 107 patients with truncus repair 34 patients had at least 1 coronary lesion. Median follow-up time was 7 years, with 85% 5-year survival. Coronary lesions including ostial stenosis, intramurality, and juxtacommissural origin were associated with increased mortality, whereas single coronaries did not impact survival. Eleven patients had 1 coronary lesion and 6 patients with 2 coronary lesions had similar (80% and 83%, respectively) 5-year survival. Eight patients with 3 coronary lesions had 24% 5-year survival (P = .0003). Among patients with 1 or 2 lesions, surgical intervention on the coronary lesions tended to be associated with longer 5-year survival (100% vs 62%, respectively; P = .06). All patients with 3 lesions underwent coronary artery intervention, with 24% 5-year survival. CONCLUSIONS: Impact of coronary lesions on mortality after truncus repair increases with the number of lesions. Coronary artery intervention may be associated with improved time-related survival among patients with 1 or 2 lesions. Patients with the most complex anomalies (3 lesions) have poor survival and warrant ongoing study of repair techniques.


Subject(s)
Coronary Vessel Anomalies/mortality , Coronary Vessels/surgery , Postoperative Complications/mortality , Truncus Arteriosus, Persistent/surgery , Truncus Arteriosus/surgery , Vascular Surgical Procedures/methods , Coronary Vessel Anomalies/diagnosis , Coronary Vessels/diagnostic imaging , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Reoperation , Retrospective Studies , Risk Factors , Survival Rate/trends , Texas/epidemiology , Treatment Outcome , Truncus Arteriosus/diagnostic imaging , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus, Persistent/mortality
10.
BMJ Case Rep ; 13(11)2020 Nov 04.
Article in English | MEDLINE | ID: mdl-33148593

ABSTRACT

Truncus arteriosus, interrupted aortic arch and amniotic band syndrome are rare conditions. We report a case of a 38-year-old pregnant woman who was diagnosed on a routine morphological ultrasound scan with a Van Praagh type A4 persistent truncus arteriosus with an aortic arch interruption type B and abnormal limbs (oedematous left hand, hypoplastic fingers on the right hand and right big toe amputation). Elective termination of the pregnancy was carried out and the pathological examination confirmed all the sonographic findings. Furthermore, an amniotic band parallel to the umbilical cord undetected during the ultrasound scans was revealed, and was entangled around the right hand, left wrist and the umbilical cord, causing strangulation. We present the unusual association of these independent pathologies and emphasise the usefulness of fetal autopsy in all cases of pregnancy termination and abnormal ultrasound findings to make the complete diagnosis.


Subject(s)
Abnormalities, Multiple , Amniotic Band Syndrome/diagnosis , Prenatal Diagnosis/methods , Rare Diseases , Truncus Arteriosus, Persistent/diagnosis , Adult , Amniocentesis/methods , Amniotic Band Syndrome/complications , Diagnosis, Differential , Echocardiography/methods , Female , Humans , Pregnancy , Truncus Arteriosus, Persistent/etiology
11.
World J Pediatr Congenit Heart Surg ; 11(4): 507-508, 2020 07.
Article in English | MEDLINE | ID: mdl-32645768

ABSTRACT

Truncus arteriosus (TA) or common arterial trunk is a congenital cardiac anomaly having high association with arch anomalies such as right aortic arch or aortic arch interruption. However, TA with double aortic arch (DAA) is a rare occurrence. We report a case of TA with DAA where the diagnosis of DAA was missed initially.


Subject(s)
Abnormalities, Multiple , Aorta, Thoracic/abnormalities , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus/abnormalities , Vascular Ring/diagnosis , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Cardiac Surgical Procedures/methods , Humans , Infant , Male , Tomography, X-Ray Computed , Truncus Arteriosus/diagnostic imaging , Truncus Arteriosus/surgery , Truncus Arteriosus, Persistent/surgery , Vascular Ring/surgery
12.
Article in English | MEDLINE | ID: mdl-33577148

ABSTRACT

Truncus arteriosus, an anomaly of the conotruncus, is an extremely rare congenital heart disease that affects 1.19% of all patients with congenital heart diseases.  We present a surgical technique using an 8-mm cryopreserved aortic root homograft in the aortic position and a 12-mm pulmonary valved conduit in the right position that allowed us to correct this rare congenital malformation.  The cryopreserved aortic root homograft was considered a priority option for surgical correction.  The neonatal Bentall (micro-Bentall) procedure is a surgically demanding procedure but can be performed successfully by an experienced surgeon.  If we were performing a non-salvage procedure, we would have chosen a decellularized allograft.


Subject(s)
Aorta, Thoracic/transplantation , Cardiac Surgical Procedures/methods , Cryopreservation/methods , Truncus Arteriosus, Persistent/surgery , Echocardiography/methods , Humans , Infant, Newborn , Transplantation, Homologous , Truncus Arteriosus, Persistent/diagnosis
13.
Am J Cardiol ; 124(10): 1636-1642, 2019 11 15.
Article in English | MEDLINE | ID: mdl-31540664

ABSTRACT

The cardiovascular magnetic resonance imaging (CMR) features of adults with repaired truncus arteriosus (rTA) are largely undefined. We sought to explore CMR characteristics in rTA and to identify associations between imaging findings and cardiovascular outcomes. Adults with rTA and CMR were identified and anatomic subtypes (1-4) were assigned (Collett and Edwards classification). CMR characteristics, clinical data at last follow-up and adverse cardiovascular outcome were recorded. Twenty-seven adults (19% male) were studied (median age at cardiovascular magnetic resonance 26 years [interquartile range 18 to 40]) over 5.2-year duration [interquartile range 2.5 to 7.5]. With the exception of mildly increased RV mass (30 ± 12 g/m2), cardiac chamber measurements were within the normal range. In CMR measurements, only pulmonary artery peak velocity differed in subtypes (highest in subtype 3, 318 ± 26 cm/s, p = 0.029). Number of cardiovascular interventions in adulthood was moderately correlated with left ventricular end-diastolic volume (r = 0.463, p = 0.015), left ventricular ejection fraction (r = 0.425, p = 0.027) and neoaortic root size (r = 0.398, p = 0.039). Cardiovascular events (nonmutually exclusive) in 5 of 27 patients (19%) included death (n = 1), heart failure (n = 1), ventricular tachycardia (n = 1), and atrial tachycardia (n = 3). Increased cardiovascular risk was associated with decreased right ventricular ejection fraction (odds ratio 1.153, confidence interval 1.003 to 1.326, p = 0.046) and smaller ascending aorta diameter (odds ratio 1.758, confidence interval 1.037 to 2.976, p = 0.036). In conclusion, decreased right ventricular ejection fraction and smaller ascending aorta on cardiovascular magnetic resonance were associated with adverse events in rTA.


Subject(s)
Cardiac Surgical Procedures/methods , Heart Ventricles/diagnostic imaging , Magnetic Resonance Imaging, Cine/methods , Truncus Arteriosus, Persistent/surgery , Truncus Arteriosus/diagnostic imaging , Adolescent , Adult , Female , Follow-Up Studies , Heart Ventricles/physiopathology , Humans , Male , Postoperative Period , Retrospective Studies , Truncus Arteriosus, Persistent/diagnosis , Truncus Arteriosus, Persistent/physiopathology , Young Adult
14.
Can J Cardiol ; 35(4): 446-452, 2019 04.
Article in English | MEDLINE | ID: mdl-30935635

ABSTRACT

BACKGROUND: Common arterial trunk (CAT) is a rare anomaly with a spectrum of pathology. We sought to identify current trends and factors associated with postnatal outcomes. METHODS: This was a single-centre review including 153 live births with planned surgery. Patients were analyzed as 2 cohorts based on era of CAT diagnosis (1990 to 1999 vs 2000 to 2014) and complexity of disease (simple vs complex). "Complex" required the association with significant aortic arch obstruction, truncal valve (TV) stenosis/regurgitation, and/or branch pulmonary artery (PA) hypoplasia, respectively. RESULTS: Sixteen (10%) died preoperatively, and this outcome was associated with significant TV stenosis (odds ratio [OR] 4.55; P = 0.01) and regurgitation (OR 3.17; P = 0.04); 130 (95%) of 137 operated infants underwent primary complete repair. Their survival rates to 1 year improved from 54% to 85% after 2000, although this outcome remained substantially lower for cases with a complex vs simple CAT repair (76% vs 95%; OR 6.46; P = 0.006). Other risk factors associated with decreased 1-year survival included diagnosis before 2000 (OR 4.48; P = 0.038) and a lower birth weight (OR 8.0 per kg weight; P = 0.001). Finally, of 93 survivors beyond year 1 of life, 76 (82%) had undergone a total of 224 reinterventions. Only 15 (16%) were alive without any surgical or catheter-based reintervention at study end. CONCLUSIONS: Despite recent surgical improvements, postnatal mortality continues to be substantial if CAT is complicated by significant pathology of the TV, aortic arch, or branch PAs. Reoperations and catheter interventions are eventualities for most patients during childhood.


Subject(s)
Truncus Arteriosus, Persistent/epidemiology , Truncus Arteriosus, Persistent/surgery , Abnormalities, Multiple/epidemiology , Abortion, Induced/statistics & numerical data , Child , Child, Preschool , Cohort Studies , Female , Follow-Up Studies , Humans , Infant , Infant Mortality , Infant, Low Birth Weight , Infant, Newborn , Male , Ontario/epidemiology , Pregnancy , Prenatal Diagnosis , Reoperation/statistics & numerical data , Retrospective Studies , Severity of Illness Index , Truncus Arteriosus, Persistent/diagnosis
15.
Ann Thorac Surg ; 108(2): e105-e106, 2019 08.
Article in English | MEDLINE | ID: mdl-30710524

ABSTRACT

Truncus arteriosus with the absence of one branching pulmonary artery and presence of major aortopulmonary collateral arteries is rare. A small patient, with a birth weight of 2,219 g, was successfully repaired by a staged approach, after banding of the left pulmonary artery and unifocalization of major aortopulmonary collateral arteries.


Subject(s)
Abnormalities, Multiple/diagnosis , Aorta, Thoracic/abnormalities , Collateral Circulation , Pulmonary Artery/abnormalities , Truncus Arteriosus, Persistent/diagnosis , Abnormalities, Multiple/surgery , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Aortography , Cardiac Surgical Procedures/methods , Humans , Infant, Newborn , Male , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Tomography, X-Ray Computed , Truncus Arteriosus, Persistent/surgery , Vascular Surgical Procedures/methods
17.
Cardiol Young ; 29(3): 414-415, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30714544

ABSTRACT

We present a case of a 3-week-old boy with persistent truncus arteriosus associated with interrupted right aortic arch having an anomalous origin of the left vertebral artery from the ascending aorta.


Subject(s)
Abnormalities, Multiple , Aorta, Thoracic/abnormalities , Truncus Arteriosus, Persistent/diagnosis , Vascular Malformations/diagnosis , Vertebral Artery/abnormalities , Aorta, Thoracic/diagnostic imaging , Computed Tomography Angiography , Diagnosis, Differential , Humans , Infant, Newborn , Male , Vertebral Artery/diagnostic imaging
18.
World J Pediatr Congenit Heart Surg ; 10(3): 384-387, 2019 05.
Article in English | MEDLINE | ID: mdl-28610465

ABSTRACT

Surgical management of truncus arteriosus, or common arterial trunk, has expanded over the past three decades to include earlier surgical intervention, initially during infancy and now chiefly in the neonatal period. Many studies have shown that preoperative truncal valve insufficiency is an independent risk factor for mortality. We herein present the case of a five-month-old boy with severe truncal valve insufficiency who underwent repair of common arterial trunk and prosthetic replacement of the truncal valve with associated annular enlargement after initial stabilization in the newborn period via palliative bilateral pulmonary artery banding. We believe that initial bilateral pulmonary artery banding represents a viable option for some cases of common arterial trunk involving truncal valve insufficiency.


Subject(s)
Heart Valve Prosthesis , Heart Valves/surgery , Pulmonary Artery/surgery , Thoracic Surgical Procedures/methods , Truncus Arteriosus, Persistent/surgery , Truncus Arteriosus/surgery , Follow-Up Studies , Humans , Infant, Newborn , Male , Truncus Arteriosus/abnormalities , Truncus Arteriosus, Persistent/diagnosis
19.
Asian Cardiovasc Thorac Ann ; 26(7): 570-573, 2018 Sep.
Article in English | MEDLINE | ID: mdl-27151928

ABSTRACT

A neonate, born after 29 weeks and 2 days gestation (weight 1015 g), was diagnosed with truncus arteriosus and interrupted aortic arch. On postnatal day 30 (1378 g), we performed bilateral pulmonary artery banding. On postnatal day 107 (3024 g), we carried out aortic arch repair and a Rastelli-type procedure. During follow-up, branch pulmonary artery and ascending aortic stenosis was observed. At 15 months, surgical angioplasty of the ascending aorta and bilateral branch pulmonary arteries was undertaken using the Lecompte maneuver.


Subject(s)
Abnormalities, Multiple , Aorta, Thoracic/abnormalities , Infant, Very Low Birth Weight , Truncus Arteriosus, Persistent/diagnosis , Vascular Surgical Procedures/methods , Angiography , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/surgery , Female , Humans , Imaging, Three-Dimensional , Infant, Newborn , Tomography, X-Ray Computed , Truncus Arteriosus, Persistent/surgery
20.
World J Pediatr Congenit Heart Surg ; 9(1): 117-120, 2018 01.
Article in English | MEDLINE | ID: mdl-27619329

ABSTRACT

An intramural coronary artery in the setting of truncus arteriosus (common arterial trunk) is an uncommon association. Following an uneventful surgical repair, a neonate developed a low cardiac output state deteriorating into cardiac arrest shortly after arrival into the intensive care unit, requiring extracorporeal membrane oxygenation support. Echocardiography and angiography showed occlusion of the left coronary artery, prompting emergency surgical reexploration. A "slit-like" orifice with an intramural left coronary artery was successfully unroofed, allowing full recovery. Full definition of the proximal coronary anatomy beyond the orifices should be investigated preoperatively in truncus arteriosus, as a missed intramural segment could lead to significant morbidity or mortality.


Subject(s)
Truncus Arteriosus, Persistent/diagnosis , Cardiac Output, Low/diagnosis , Cardiac Output, Low/surgery , Coronary Vessels/surgery , Extracorporeal Membrane Oxygenation , Female , Humans , Infant, Newborn , Treatment Outcome , Truncus Arteriosus/abnormalities , Truncus Arteriosus/pathology , Truncus Arteriosus/surgery , Truncus Arteriosus, Persistent/surgery
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