© 2021 Wiley Periodicals LLC
Journal of Cardiac Surgery (2021) 1-5
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
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
Children’s Heart Center Nevada, 3006 S Maryland Parkway, Ste 690, Las Vegas, NV 89109, USA. Email: WNevans50@aol.com.
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.