SURGICAL TECHNIQUES AND LONG-TERM RESULTS
Alternative Nonvalved Techniques for Repair of Truncus Arteriosus: Long-Term Results
Miguel Barbero-Marcial and Carla Tanamati
Primary early repair has been advocated as the preferred surgical approach to truncus arteriosus in infancy. This approach usually includes the reconstruction of the right ventricle outflow tract using a valved extracardiac conduit. However, the longevity of these conduits and the risk of their replacement have been a subject of major concern. When used in early infancy, these conduits require repeated replacement because of internal obstruction or because the patient has outgrown the conduit. Our group first described the possibility of correction without an extracardiac conduit in 1990, although it has been performed at our institution since 1987. The ideal candidates for this type of correction include patients up to 5 months of age who have truncus arteriosus type I or II (Colllet-Edwards classification), no anomalous trajectory of the coronary artery crossing anteriorly to the truncus, and no significant pulmonary vascular resistance (pulmonary vascular resistance <7 Wood units). This surgical technique is described and the outcomes reviewed.
Key words: Truncus arteriosus, extracardiac conduit.
From the Pediatric Cardiac Surgery Department, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil.
Address reprint requests to Miguel Barbero-Marcial, MD, Heart Institute, University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44, CEP 05403-000, São Paulo, Brazil.
© 1999 by W.B. Saunders Company
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