{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:53:33Z","timestamp":1790024013407,"version":"4.0.1"},"reference-count":46,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951123000604_as1\"><jats:title>Background:<\/jats:title><jats:p>Infants with truncus arteriosus typically undergo repair by repurposing the truncal valve as the neo-aortic valve and using a valved conduit homograft for the neo-pulmonary valve. In cases where the native truncal valve is too insufficient for repair, it is replaced, but this is a rare occurrence with a paucity of data, especially in the infant population. Here, we conduct a meta-analysis to better understand the outcomes of infant truncal valve replacement during the primary repair of truncus arteriosus.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000604_as2\"><jats:title>Methods:<\/jats:title><jats:p>We systematically reviewed PubMed, Scopus, and CINAHL for all studies reporting infant (&lt;12 months) truncus arteriosus outcomes between 1974 and 2021. Exclusion criteria were studies which did not report truncal valve replacement outcomes separately. Data extracted included valve replacement type, mortality, and reintervention. Our primary outcome was early mortality, and our secondary outcomes were late mortality and reintervention rates.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000604_as3\"><jats:title>Results:<\/jats:title><jats:p>Sixteen studies with 41 infants who underwent truncal valve replacement were included. The truncal valve replacement types were homografts (68.8%), mechanical valves (28.1%), and bioprosthetic valves (3.1%). Overall early mortality was 49.4% (95% CI: 28.4\u201370.5). The pooled late mortality rate was 15.3%\/year (95% CI: 5.8\u201340.7). The overall rate of truncal valve reintervention was 21.7%\/year (95% CI: 8.4\u201355.7).<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123000604_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Infant truncal valve replacement has poor early and late mortality as well as high rates of reintervention. Truncal valve replacement therefore remains an unsolved problem in congenital cardiac surgery. Innovations in congenital cardiac surgery, such as partial heart transplantation,\u00a0are required to address this.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951123000604","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T08:18:41Z","timestamp":1679905121000},"page":"673-680","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":27,"title":["Outcomes of truncal valve replacement in neonates and infants: a meta-analysis"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-7254","authenticated-orcid":false,"given":"William A.","family":"Hardy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Turek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Konrad","family":"Rajab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"key":"S1047951123000604_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.06.036"},{"key":"S1047951123000604_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)32803-1"},{"key":"S1047951123000604_ref26","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.9.128"},{"key":"S1047951123000604_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.12.052"},{"key":"S1047951123000604_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(65)90732-0"},{"key":"S1047951123000604_ref45","unstructured":"45. Turek, JW , Kang, L , Hoover, A , et al., A New Operation for Truncus Arteriosus with Unrepairable Truncal Valve: The First Human Partial Heart Transplant, Presented at: Congenital Heart Surgeons' Society; 2022; Chicago, IL. Session 49th Annual Meeting. https:\/\/meeting.chss.org\/program\/2022\/A13.cgi"},{"key":"S1047951123000604_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.06.018"},{"key":"S1047951123000604_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(01)00816-8"},{"key":"S1047951123000604_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00227-2"},{"key":"S1047951123000604_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"S1047951123000604_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34168-6"},{"key":"S1047951123000604_ref19","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1348"},{"key":"S1047951123000604_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.06.072"},{"key":"S1047951123000604_ref36","doi-asserted-by":"publisher","DOI":"10.1177\/2150135119888141"},{"key":"S1047951123000604_ref15","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300117"},{"key":"S1047951123000604_ref43","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.07.051"},{"key":"S1047951123000604_ref9","doi-asserted-by":"publisher","DOI":"10.1177\/2150135115608093"},{"key":"S1047951123000604_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy080"},{"key":"S1047951123000604_ref22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"S1047951123000604_ref31","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02785-0"},{"key":"S1047951123000604_ref20","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/37.3-4.256"},{"key":"S1047951123000604_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.07.039"},{"key":"S1047951123000604_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"S1047951123000604_ref42","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.17050"},{"key":"S1047951123000604_ref40","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951121003760"},{"key":"S1047951123000604_ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.02.003"},{"key":"S1047951123000604_ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02405-z"},{"key":"S1047951123000604_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(00)70130-9"},{"key":"S1047951123000604_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/0011-3840(89)90017-8"},{"key":"S1047951123000604_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(97)01064-3"},{"key":"S1047951123000604_ref23","article-title":"A package for survival analysis in S","volume":"2","author":"Therneau","year":"2015","journal-title":"R Package Version"},{"key":"S1047951123000604_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(90)90671-R"},{"key":"S1047951123000604_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"S1047951123000604_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(01)00717-5"},{"key":"S1047951123000604_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.09.083"},{"key":"S1047951123000604_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)33780-8"},{"key":"S1047951123000604_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.08.022"},{"key":"S1047951123000604_ref44","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0280163"},{"key":"S1047951123000604_ref25","first-page":"1182","article-title":"[Total repair for truncus arteriosus]","volume":"40","author":"Yaku","year":"1992","journal-title":"Nihon Kyobu Geka Gakkai Zasshi"},{"key":"S1047951123000604_ref46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2013.09.023"},{"key":"S1047951123000604_ref38","first-page":"334","article-title":"The homograft aortic valve: a 29-year, 99.3% follow up of 1,022 valve replacements","volume":"10","author":"O'Brien","year":"2001","journal-title":"J Heart Valve Dis"},{"key":"S1047951123000604_ref16","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177729756"},{"key":"S1047951123000604_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.04.121"},{"key":"S1047951123000604_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198410000-00006"},{"key":"S1047951123000604_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00304-4"},{"key":"S1047951123000604_ref18","first-page":"138","article-title":"The inverse of the Freeman-Tukey double arcsine transformation","volume":"32","author":"Miller","year":"1978","journal-title":"Am Statist."}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951123000604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T08:48:44Z","timestamp":1706172524000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951123000604\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,27]]},"references-count":46,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,5]]}},"alternative-id":["S1047951123000604"],"URL":"https:\/\/doi.org\/10.1017\/s1047951123000604","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,27]]},"assertion":[{"value":"\u00a9 The Author(s), 2023. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}