SHORT REPORT|Articles in Press

Impact of truncal valve repair on survival, reintervention, and left ventricular function

Open AccessPublished:March 08, 2023DOI:
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      Truncal valve insufficiency (TVI) is one of the risk factors for death in neonatal primary repair for common arterial trunk (CAT).


      In this single-center retrospective case-matched controlled study, 16 consecutive CAT patients from 2000- 2018 with moderate to severe truncal valve regurgitation (TVR2-3) undergoing primary CAT surgery with truncal valve (TrV) repair were matched to 16 CAT patients with none to mild truncal valve regurgitation (TVR1-0).


      The TVR2-3 group had 11 (69%) patients with moderate and 5 (31%) with severe TVI, with an operative median age of 7(4 – 19) days. Survival at median follow-up of 17 years post-repair was 70% and 80% in the TVR2-3 and TVR0-1 groups, respectively (p> 0.99), with two early deaths in the TVR2-3 group occurring after reintervention for residual TVI. Rate of surgical TrV re-intervention at 5 years postoperative was 67% for TVR2-3 (p = 0.005). TVR2-3 experienced greater residual TVI at discharge and 1-year post-repair with severity of TrV dysfunction converging between groups as more patients in TVR0-1 developed mild/moderate TVI over time and TVR2-3 patients underwent re-intervention for clinically significant TVI. Significant LV dilation was observed in the TVR2-3 group after 3 years post-repair (p = 0.001), but LVEF was comparable between groups.


      TrV reintervention burden (i.e. repair or replacement) is greater in the TVR2-3 population with higher truncal valve-related early mortality. Progressive LV enlargement in the TVR2-3 group due to residual TVI was well tolerated. Ventricular remodeling did not significantly impact LVEF or clinical status.

      Graphical abstract


      CAT (common arterial trunk), ECMO (extracorporeal membrane oxygenation), LV (left ventricle), LVEF (left ventricular ejection fraction), TrV (truncal valve), TVI (truncal valve insufficiency), TVS (truncal valve stenosis)