Contemporary Multicenter Outcomes for Truncus Arteriosus With Interrupted Aortic Arch

BACKGROUND Truncus arteriosus with interrupted aortic arch (TA-IAA) is a rare congenital heart defect with histori-cally poor outcomes. Contemporary multicenter data are limited.METHODS A retrospective cohort study of children who underwent repair of TA-IAA between 2009 and 2016 at 12 tertiary care referral centers within the United States was performed. Major adverse cardiac events (MACE) were defined as postoperative extracorporeal membrane oxygenation, cardiopulmonary resuscitation, or operative mortality. TA-IAA patients were compared with TA patients who underwent repair during the study period from the same institutions.RESULTS We reviewed 35 patients with TA-IAA. MACE occurred in 12 patients (34%). Improvement over time was observed during the study period with 11 events (92%) occurring in the first half of the study period (P = .03). Factors associated with MACE included moderate or severe truncal valve insufficiency (P < .01), concomitant truncal valve repair (P = .04), and longer cardiopulmonary bypass duration (P = .02). In comparison with 216 patients who underwent TA repair, patients with TA-IAA had a higher rate of MACE, but this finding was not statistically significant (34% vs 20%, respectively; P = .07). Additionally no differences between TA-IAA and TA groups were observed for unplanned reoperations (14% vs 22%, respectively; P = .3), hospital length of stay (24 vs 23 days, P = .65), or late deaths (7% vs 7%, P = 1.00).CONCLUSIONS In this contemporary, multicenter cohort the rate of MACE after repair of TA-IAA was high but improved during the study period. Early childhood outcomes of patients with TA-IAA were similar to those with TA.(Ann Thorac Surg 2023;115:144-51)(c) 2023 by The Society of Thoracic Surgeons

Automated summary

This retrospective cohort study evaluated the outcomes of 35 children who underwent repair of TA-IAA in 12 tertiary care referral centers in the United States. The rate of MACE was 34%, which was higher than that of TA patients but not statistically significant. The study suggested that early childhood outcomes of patients with TA-IAA were similar to those with TA.