© 2021 Wiley Periodicals
LLC
Journal of Cardiac
Surgery (2021) 1-5
DOI 10.1111/jocs.15964
Received: 05 August 2021
/ Accepted: 22 August 2021
Common arterial trunk in the era of
high prenatal detection rates: Results of neonatal palliation and primary
repair
Authors
William N Evans,
MD, Ruben J Acherman, MD, Michael L Ciccolo, MD, Juan Lehoux, MD, Alvaro
Galindo, MD, Abraham Rothman, MD, Gary A Mayman, MD,
Humberto Restrepo, MD, MPH
Source
Children’s Heart
Center Nevada, 3006 S Maryland Parkway, Ste 690, Las Vegas, NV 89109, USA. Email:
WNevans50@aol.com.
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 echo-cardiogram, 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 catheteriza-tion 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.