| Abstract
| - OBJECTIVE: Evaluation of a consistent policy of elective repair oftruncus arteriosus at 2-3 months of age for the patients who areindependent of hospital ward care, and long-term outcome. METHODS:Retrospective study of 82 patients with truncus arteriosus who underwenttotal repair at the Victorian Paediatric Cardiac Surgical Unit between 1979and December 1995. The timing was based on a consistent policy of electiverepair at 2-3 months of age for patients who were independent of hospitalward care. Earlier repair was performed when the patients were inuncontrolled congestive heart failure. RESULTS: Follow-up was complete forall patients with a mean of 76 months (1-183). There were 11 hospitaldeaths (13.4% CL 9-18.5), and five late deaths, actuarial survival at 80months was 81% (CL 70- 88%) with 39 patients uncensored at that point. Forthe purpose of this presentation, patients have been grouped according totheir age at repair; 1, neonates n = 17 (hospital mortality = 5); 2,infants 1-6 months of age n = 48 (hospital mortality = 4); 3, patientsbeyond 6 months n = 17 (hospital mortality = 2). This series includes 10patients with interrupted aortic arch with no mortality, and 10 patientswith discontinuous pulmonary artery (hospital mortality = 2). Thirty-sevenpatients have had 54 conduits replaced to date. Using multiple regression,body weight < 3 kg was the only significant independent risk factor forhospital mortality. CONCLUSIONS: Our management policy tended to gatherpatients with risk factors described elsewhere into presentation group 1and low risk truncus patients into presentation group 2. Deferral ofsurgery to 2-3 months of age is possible and lowers the surgical risk.
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