Study about Late Follow-Up of Persistent Truncus Arteriosus, after One- Stage Repair, Using a Biological Bicuspid Prosthesis to Pulmonary Valve Reconstruction
In a two-month-old girl with Persistent Truncus Arteriosus type I, II, we describe long-term outcomes after a one-stage surgical correction. The procedure involved the modification of the right ventricle and the use of a swine bicuspid pulmonary prosthesis. The patient is in great clinical health, with CF I (NYHA) and normal peripheral oxygen saturation, twenty-six years later. Recent invasive and non-invasive imaging reveals: no intracardiac shunt, increasing right ventricle outlet tract, and distinct pulmonary valve double lesion. Both lungs receive the same amount of pulmonary flow. In some circumstances, patients with truncus arteriosus who have early surgical repair and avoid the use of a valved conduit have a favourable long-term prognosis, requiring no subsequent procedures. Endovascular procedures for implantation of a pulmonary valve stent through a catheter, which are now well standardised, will allow an effective approach in the presence of late obstructions in patients who have undergone right ventricular remodelling without the use of valved conduits in patients who have undergone right ventricular remodelling. Over the course of the long follow-up, it was decided that ventricular remodelling with pulmonary valve repair allowed for the maintenance of right ventricular function and the patient’s advancement to functional class I (NYHA) with no restrictions on her physical activity.
Cardiovascular Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.