Abstract：
BACKGROUND: This study describes the 20-year experience of managing common arterial trunk (CAT) in a low-and-middle-income country and compares the early and medium-term outcomes following the transition from conduit to nonconduit repair at the Red Cross War Memorial Children\'s Hospital.
METHODS: Single-center retrospective study of consecutive patients aged less than 18 years who underwent repair of CAT from January 1999 to December 2018 at the Red Cross War Memorial Children\'s Hospital. Patients with interrupted aortic arch or previous pulmonary artery banding were excluded.
RESULTS: Fifty-four patients had CAT repair during the study period. Thirty-four (63.0%) patients had a conduit repair, and 20 (37.0%) patients had a nonconduit repair. There were two intraoperative deaths. Thirty-day in-hospital mortality was 22.2% (12/54). Overall, in-hospital mortality was 29.6% (16/54). Eight (21.1%) late mortalities were observed. The actuarial survival for the conduit group was 77.5%, 53.4%, and 44.5% at 6, 12, and 27 months, respectively, and the nonconduit group was 58.6% at six months. The overall freedom from reoperation between the conduit group and nonconduit group was 66.2% versus 86.5%, 66.2% versus 76.9%, and 29.8% versus 64.1% at 1, 2, and 8 years, respectively.
CONCLUSIONS: The outcomes following the transition to nonconduit repair for CAT in a low- and middle-income setting appear to be encouraging. There was no difference in mortality between conduit and nonconduit repairs, and importantly the results suggest a trend toward lower reintervention rates.
METHODS: Single-center retrospective study of consecutive patients aged less than 18 years who underwent repair of CAT from January 1999 to December 2018 at the Red Cross War Memorial Children\'s Hospital. Patients with interrupted aortic arch or previous pulmonary artery banding were excluded.
RESULTS: Fifty-four patients had CAT repair during the study period. Thirty-four (63.0%) patients had a conduit repair, and 20 (37.0%) patients had a nonconduit repair. There were two intraoperative deaths. Thirty-day in-hospital mortality was 22.2% (12/54). Overall, in-hospital mortality was 29.6% (16/54). Eight (21.1%) late mortalities were observed. The actuarial survival for the conduit group was 77.5%, 53.4%, and 44.5% at 6, 12, and 27 months, respectively, and the nonconduit group was 58.6% at six months. The overall freedom from reoperation between the conduit group and nonconduit group was 66.2% versus 86.5%, 66.2% versus 76.9%, and 29.8% versus 64.1% at 1, 2, and 8 years, respectively.
CONCLUSIONS: The outcomes following the transition to nonconduit repair for CAT in a low- and middle-income setting appear to be encouraging. There was no difference in mortality between conduit and nonconduit repairs, and importantly the results suggest a trend toward lower reintervention rates.
摘要：
背景：这项研究描述了在中低收入国家管理总动脉干（CAT）20年的经验，并比较了红十字战争纪念儿童医院从导管过渡到非导管修复后的早期和中期结果。
方法：对1999年1月至2018年12月在红十字战争纪念儿童医院接受CAT修复的年龄小于18岁的连续患者进行单中心回顾性研究。排除主动脉弓中断或先前肺动脉束带的患者。
结果：54例患者在研究期间接受了CAT修复。34例（63.0%）患者进行了导管修复，20例（37.0％）患者进行了非导管修复。术中死亡2例。30天住院死亡率为22.2%(12/54)。总的来说,住院死亡率为29.6%(16/54).观察到8例（21.1％）晚期死亡率。导管组的精算生存率为77.5%,53.4%,在6个月、12个月和27个月时为44.5%，分别,6个月时，非导管组为58.6%。导管组和非导管组的再手术总自由度分别为66.2%和86.5%，66.2%对76.9%，在1年、2年和8年，分别为29.8%和64.1%，分别。
结论：在低收入和中等收入环境中，CAT过渡到非导管修复后的结果似乎令人鼓舞。导管和非导管修复之间的死亡率没有差异，重要的是，结果表明了降低再干预率的趋势。
方法：对1999年1月至2018年12月在红十字战争纪念儿童医院接受CAT修复的年龄小于18岁的连续患者进行单中心回顾性研究。排除主动脉弓中断或先前肺动脉束带的患者。
结果：54例患者在研究期间接受了CAT修复。34例（63.0%）患者进行了导管修复，20例（37.0％）患者进行了非导管修复。术中死亡2例。30天住院死亡率为22.2%(12/54)。总的来说,住院死亡率为29.6%(16/54).观察到8例（21.1％）晚期死亡率。导管组的精算生存率为77.5%,53.4%,在6个月、12个月和27个月时为44.5%，分别,6个月时，非导管组为58.6%。导管组和非导管组的再手术总自由度分别为66.2%和86.5%，66.2%对76.9%，在1年、2年和8年，分别为29.8%和64.1%，分别。
结论：在低收入和中等收入环境中，CAT过渡到非导管修复后的结果似乎令人鼓舞。导管和非导管修复之间的死亡率没有差异，重要的是，结果表明了降低再干预率的趋势。
