This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by MAIR, D. D. Articles by MCGOON, D. C. Search for Related Content PubMed PubMed Citation Articles by MAIR, D. D. Articles by MCGOON, D. C.

(Circulation. 1974;49:144.)
© 1974 American Heart Association, Inc.

---

Selection of Patients with Truncus Arteriosus for Surgical Correction

Anatomic and Hemodynamic Considerations

DOUGLAS D. MAIR M.D.¹; DONALD G. RITTER M.D.¹; GEORGE D. DAVIS M.D.¹; ROBERT B. WALLACE M.D.¹; GORDON K. DANIELSON M.D.¹; DWIGHT C. MCGOON M.D.¹

¹ From the Mayo Clinic and Mayo Foundation, Rochester Minnesota.

Six years have passed since the first successful surgical correction of truncus arteriosus. A review of our experience enables some conclusions regarding the operation. Patients with mild or moderate truncal valve incompetence do not need truncal valve replacement. Patients with severe truncal valve incompetence require valve replacement, which is associated with a significantly increased surgical mortality. The surgical mortality is not increased in hemodynamically favorable patients who have only one pulmonary artery. However, these patients are especially likely to have early development of severe pulmonary vascular disease. The surgical mortality for the patient with uncomplicated disease and two pulmonary arteries, with pulmonary resistance of less than 8.0 units m², is 10%. In patients with pulmonary resistance between 8.0 and 12 units m², the mortality is approximately three times greater. Patients with pulmonary resistances greater than 12.0 units m² are probably inoperable. Different hemodynamic criteria must be applied in assessing the operability of patients with a single pulmonary artery. A systemic arterial oxygen saturation less than 85% in a patient with two pulmonary arteries and without pulmonary artery stenosis or a pulmonary artery band usually indicates inoperability. Elective operation usually is deferred until a patient is four years old, but if the patient's clinical condition warrants, the procedure can be done at any time after the age of one year, with a good chance of success. Follow-up on most operated patients has been encouraging.

Key Words: Absent pulmonary artery • Pulmonary artery banding • Rastelli operation • Hypertensive pulmonary vascular disease • Systemic arterial oxygen saturation • Truncal valve incompetence • Aortic arch interruption

Submitted on July 24, 1973
Accepted on August 22, 1973

This article has been cited by other articles:

				S. Conte, T. Jensen, J. R. Jacobsen, F. S. Joyce, P. Lauridsen, and G. Pettersson One-Stage Repair of Truncus Arteriosus, CAVC, and TAPVC Ann. Thorac. Surg., June 1, 1997; 63(6): 1781 - 1783. [Abstract] [Full Text]

				F. Berdjis, W. J. Wells, and V. A. Starnes Truncus Arteriosus With Total Anomalous Pulmonary Venous Return and Interrupted Arch Ann. Thorac. Surg., January 1, 1996; 61(1): 220 - 222. [Abstract] [Full Text]