From 1983, until June, 1990, 10 patients with various type of truncus arteriosus underwent total surgical correction including Rastelli procedure at Seoul National University Hospital. The age at operation ranged from I month to 9 years (mean 2.1 years). Six patients had truncus type 1, 3 patients had truncus type 11, and one patients had truncus type Mc. Right ventricular pulmonary artery continuity was established with a porcine valved condutit in 6 patients, mechanical valved conduit in 1 patient, and bovine pericardial conduit in 3 patients. The postoperative right ventriCular /left ventricular pressure ratio ranged from 0.4 to 0.71 (mean 0.5110.14). The lung histology revealed grade 11 pulmonary obstructive disease even at 4 month of age. Five patients were dead in hospital (50%), and they were less than 2 year of age. One patient, who- had severs congestive heart failure preoperatively, died of low output syndrome and the other died of low output syndrome with posteoperative bleeding. There were three death, because of a pulmonary hypertensive crisis that might have been prevented. Two of the five survivors had conduit failure over a mean follow up of 42 months (range 1 to 78 months). Obstructed conduit was removed and a new conduit constructed using the conduit bed as the posterior wall and the patch of bovine pericardium and Dacron as patch the roof of the conduit. One patient died of acute cardiac failure during the operation.
Although results in infants less than 2 years old have not bee good, current improvement of infra-and postoperative care suggested that prompt repair is indicated for infants with truncus arteriosus.
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