Characterization of size, shape and pattern of flow in the neo-aorta and pulmonary artery in a patient following an innovative technique of repair for truncus arteriosus

Amr El Sawy, Mohamed Nagy, Ahmed Afifi, Hatem Hosny, Soha Romeih, Heba Aguib, Magdi Yacoub
Global Cardiology Science & Practice 2019 September 20, 2019 (2): e201918
31799292
Background. Truncus arteriosus (TA) caries a very poor prognosis. In the absence of early correction, only 12 percent of patients born with this anomaly survive beyond one year. There is no agreement about the best method of surgical correction of this anomaly. We have devised an innovative valveless technique using autologous arterial tissue to repair TA. Objectives. Characterizing the size, shape and pattern of flow in the neo-aorta and pulmonary artery, in a patient following the new technique. Patient and Methods. Cardiac MRI and multislice CT imaging, followed by offline computerized image analysis was used in a patient aged 3 months, within 3 weeks of operating. Results. The size, shape and topology of the neo-aorta and pulmonary artery, approximated that present in normal hearts. The pattern of flow in the reconstructed vessels was laminar, throughout the cardiac cycle with minor acceleration during systole. The pulmonary regurgitation resulting from the absence of a valve occurred during late diastole, and was well tolerated. The size of the right ventricle diminished considerably following operation, and the right ventricular ejection fraction was supernormal. Conclusion. This early study in one patient provides new unique data of the size, shape, topology and pattern of flow in the neo-aorta and pulmonary artery, which appear to approximate normality. The long-term results of this promising operation need to be studied.

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