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Hospital Survival After Surgical Repair of Truncus Arteriosus with Interrupted Aortic Arch: Results from a Multi-institutional Database

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Abstract

Truncus arteriosus (TA) is a major congenital cardiac malformation that requires surgical repair in the first few weeks of life. Interrupted aortic arch (IAA) is an associated malformation that significantly impacts the complexity of the TA operation. The aim of this study was to (1) define the comorbid conditions associated with TA and (2) determine the hospital survival and morbidity of patients with TA with and without an IAA. Data was collected from the Vizient Clinical Database/Resource Manager, formerly University HealthSystem Consortium, which encompasses more than 160 academic medical centers in the United States. The database was queried for patients admitted from 2002 to 2016 who were ≤ 4 months of age at initial admission, diagnosed with TA, and underwent complete surgical repair during that hospitalization. Of the 645 patients with TA who underwent surgery, 98 (15%) had TA with an interrupted aortic arch (TA-IAA). Both TA and TA-IAA were associated with a high prevalence of comorbidities, including DiGeorge syndrome, prematurity, and other congenital malformations. There was no difference in mortality between TA and TA-IAA (13.7–18.4%, p value = 0.227). No comorbid conditions were associated with an increased mortality in either group. However, patients with TA-IAA had a longer post-operative length of stay (LOS) compared to those without IAA (30 versus 40.3 days, p value = 0.001) and this effect was additive with each additional comorbid condition. In conclusion, the addition of IAA to TA is associated with an increased post-operative LOS, but does not increase in-hospital mortality.

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Funding

The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Division of Cardiology, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

    Brandon A. Jones & Peter N. Dean

  2. Division of Translational Research and Applied Statistics, Department of Public Health, University of Virginia School of Medicine, Charlottesville, VA, USA

    Mark R. Conaway

  3. Division of Critical Care, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

    Michael C. Spaeder

  4. Akron Children’s Hospital Heart Center, 215 West Bowery Street, Akron, OH, 44308, USA

    Brandon A. Jones

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by BAJ, MRC, MCS, and PND. The first draft of the manuscript was written by BAJ and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Brandon A. Jones.

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This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of the University of Virginia who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB of the University of Virginia.

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Jones, B.A., Conaway, M.R., Spaeder, M.C. et al. Hospital Survival After Surgical Repair of Truncus Arteriosus with Interrupted Aortic Arch: Results from a Multi-institutional Database. Pediatr Cardiol 42, 1058–1063 (2021). https://doi.org/10.1007/s00246-021-02582-5

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