Repair of persistent truncus arteriosus without a conduit: sleeve resection of the pulmonary trunk from the aorta and direct right XXXX .

@entity69577 @entity649 @entity3584 @entity338 @entity849 @entity358 @entity736 @entity204
OBJECTIVE: Establishing a new continuity between the right ventricle and the pulmonary artery is the mainstay of repair for persistent truncus arteriosus. We used the @entity69577 Viet-Neveux technique without a Lecomte maneuver to construct the connection without a conduit. Here, we retrospectively review the mid-term surgical results to examine the effectiveness of this approach. METHODS: A cylindrical segment incorporating both pulmonary artery branches was sleeve-resected from the truncal artery. The cylindrical segment was cut in the middle and two truncal arterial flaps were combined to form the posterior floor of the new pulmonary arterial trunk. The edge of the floor was attached directly to the superior margin of an oblique incision made in the left-anterior wall of the right ventricle. A @entity736 monocusp was attached to the lower half margin of the right ventricular incision. A large @entity3584 -treated pericardial patch was used to form the anterior hood of the new right ventricular outflow tract. Both great arteries were located in a normal spiral configuration. RESULTS: Ten babies (range: 3 days to 9 months of age) underwent this procedure. The Collett-Edwards classification of persistent truncus arteriosus was type I in five cases and type II in five others. There was one @entity204 due to severe @entity649 . During follow-up (36-60 months, median 54 months), only one re-operation was required to enlarge a left @entity849 . Follow-up echocardiography showed @entity338 (mild two, moderate seven, and severe one) and mild flow acceleration in the @entity358 branch and right ventricle-pulmonary artery connection in one case. CONCLUSION: This simple modification for surgical correction of persistent truncus arteriosus may be an effective alternative that overcomes conduit-related problems.
