Common arterial trunk in the era of high prenatal detection rates: Results of neonatal palliation and primary repair. Issue 11 (30th August 2021)

• Record Type: Journal Article
• Authors: Evans, William N.; Acherman, Ruben J.; Ciccolo, Michael L.; Lehoux, Juan; Galindo, Alvaro; Rothman, Abraham; Mayman, Gary A.; Restrepo, Humberto
• Is Part Of: Journal of cardiac surgery. Volume 36:Issue 11(2021)
• Page Start: 4090
• Page End: 4094
• Publication Date: 2021-08-30
• Subjects: common arterial trunk -- congenital heart disease -- palliation -- prenatal detection; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.15964
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Objective: We reviewed our center's experience with common arterial trunk. Methods: We included those with common arterial trunk in Nevada with estimated delivery dates or birth dates between June 2006 and May 2021. We excluded patients with functionally univentricular hearts. Results: We identified a total of 39: 32 prenatally and 7 postnatally. Of the 32 prenatally detected, 2 had elective termination, 2 had fetal demise, and 28 were live‐born. Of the 7 postnatally diagnosed, 6 had prenatal care without a fetal echocardiogram, and 1 had no prenatal care. Overall, live‐born prenatal detection was 28/34 (82%). Prenatal detection for 2006–2009 was 2/6 (33%) and for 2010–2021 was 26/28 (93%) p = .049. Of the 35 live‐born infants, 1 died preoperatively, and 34 underwent neonatal surgery. Of the 34, 8 had palliation (birth weight 1.9±0.7 kg, range 0.8–2.6 kg), and 26 had a primary repair (birth weight 3.0±0.3 kg, range 2.6–4.0 kg) p = .0004. For all 34 neonatal surgical procedures, there were 2 (5.9%) deaths; however, there were no subsequent surgical or interventional catheterization mortalities. Conclusions: In Nevada, current state‐wide, general population prenatal detection of the common arterial trunk was more than 90%. By employing a combination of neonatal palliation and primary repair, surgical mortality was less than 6% in a cohort that included those with birth weights less than 2.5 kg, truncal valve surgery, and interrupted aortic arches.