P448 9 year experience and outcomes of truncus arteriosus in a tertiary neonatal intensive care unit
- Resource Type
- Authors
- Shree Vishna Rasiah; Tarak Desai; Elizabeth Louise Stockley
- Source
- Abstracts.
- Subject
- congenital, hereditary, and neonatal diseases and abnormalities
Arterial trunk
Pediatrics
medicine.medical_specialty
Neonatal intensive care unit
Heart malformation
business.industry
Birth weight
Gestational age
Persistent truncus arteriosus
medicine.disease
Truncus
Conotruncal defect
cardiovascular system
Medicine
business
- Language
Background Congenital heart defect affects around 10 in a 1000 live born babies. Truncus arteriosus is a rare conotruncal defect in which a common arterial trunk supplies systemic, pulmonary and coronary circulation. The incidence of truncus arteriosus is quoted as 1% of all congenital heart malformations. Aim To evaluate the initial neonatal management and long-term outcomes of newborns with truncus arteriosus. Method We conducted a retrospective review of all newborns with truncus arteriosus admitted to our neonatal unit and referred to a surgical centre between 2010 and 2018. Data were collected from Badger and Cardiology databases to evaluate the initial neonatal management and long-term outcomes of this cohort of patients. Results Fifteen newborns with truncus arteriosus were admitted to our neonatal unit. Their mean gestational age was 36 weeks with a mean birth weight of 2407 grams. Cardiac defects were detected prenatally in 12 patients (80%). Three babies were diagnosed postnatally. One following failed pulse oximetry screening requiring non-invasive respiratory support and 2 diagnosed following on-going respiratory support on echocardiography. Respiratory support was initiated within the first 24 hours of life in 8 patients; these included all patients with a postnatal diagnosis of truncus arteriosus. Four patients required mechanical ventilation. Whilst in the neonatal intensive care unit, 3 babies developed heart failure and were treated with diuretics and 2 developed necrotising enterocolitis which was managed conservatively. Median length of stay before transfer to our local surgical cardiology centre was 3 days. Thirteen patients (87%) underwent common arterial trunk repair. 10 (77%) babies survived to date. Two patients died in the initial post-operative period and one patient at 14 months of age. The remaining two patients did not receive any surgical intervention and subsequently died (4 and 11 days old). Of the 10 babies who survived, the median length of hospital stay post operatively was 20 days. Conclusion Truncus arterisus is a rare conotruncal defect. The majority of these were detected antenatally. They are likely to require respiratory support but the surgical outcomes are good. The following information can be used when counselling parents antenatally and managing their expectations.