{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T07:04:50Z","timestamp":1785654290342,"version":"3.56.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,11,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Long\u2010term survival in patients with truncus arteriosus is favorable, but there remains significant morbidity associated with ongoing reinterventions. We aimed to study the long\u2010term outcomes of the truncal valve and identify risk factors associated with truncal valve intervention.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We retrospectively reviewed patients who underwent initial truncus arteriosus repair at our institution from 1985 to 2016. Analysis was performed on the 148 patients who were discharged from the hospital and survived \u226530\u00a0days postoperatively using multivariable competing risks Cox regression modeling. Median follow\u2010up time was 12.6\u00a0years (interquartile range, 5.0\u201322.1\u00a0years) after discharge from full repair. Thirty patients (20%) underwent at least one intervention on the truncal valve during follow\u2010up. Survival at 1, 10, and 20\u00a0years was 93.1%, 87.0%, and 80.9%, respectively. The cumulative incidence of any truncal valve intervention by 20\u00a0years was 25.6%. Independent risk factors for truncal valve intervention included moderate or greater truncal valve regurgitation (hazard ratio [HR], 4.77;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or stenosis (HR, 4.12;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) before full truncus arteriosus repair and moderate or greater truncal valve regurgitation at discharge after full repair (HR, 8.60;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). During follow\u2010up, 33 of 134 patients (25%) progressed to moderate or greater truncal valve regurgitation. A larger truncal valve root\n              <jats:italic>z<\/jats:italic>\n              \u2010score before truncus arteriosus full repair and during follow\u2010up was associated with worsening truncal valve regurgitation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Long\u2010term rates of truncal valve intervention are significant. At least moderate initial truncal valve stenosis and initial or residual regurgitation are independent risk factors associated with truncal valve intervention. Larger truncal valve root\n              <jats:italic>z<\/jats:italic>\n              \u2010score is associated with significant truncal valve regurgitation and may identify a subset of patients at risk for truncal valve dysfunction over time.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019104","type":"journal-article","created":{"date-parts":[[2020,11,9]],"date-time":"2020-11-09T10:00:16Z","timestamp":1604916016000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Long\u2010Term Fate of the Truncal Valve"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4070-4478","authenticated-orcid":false,"given":"Laura","family":"Gellis","sequence":"first","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Pediatrics Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3037-9202","authenticated-orcid":false,"given":"Geoffrey","family":"Binney","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laith","family":"Alshawabkeh","sequence":"additional","affiliation":[{"name":"Sulpizio Cardiovascular Institute University of California San Diego La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minmin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Pediatrics Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Landzberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Medicine Brigham and Women\u2019s Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Surgery Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary P.","family":"Mullen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Pediatrics Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"Valente","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Medicine Brigham and Women\u2019s Hospital Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn A.","family":"Sleeper","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Pediatrics Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Cardiology Boston Children\u2019s Hospital Boston MA"},{"name":"Department of Pediatrics Harvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.08.094"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2015.08.009"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(01)00816-8"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(97)01064-3"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.04.121"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.12.052"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.07.039"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135115608093"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2017.01.007"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781444306309"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(65)90732-0"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00551-9"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy080"},{"key":"e_1_3_1_16_2","first-page":"813","article-title":"Truncus arteriosus repair: a 40\u2010year multicenter perspective","author":"Naimo PS","year":"2020","unstructured":"Naimo PS, Bell D, Fricke TA, d\u2019Udekem Y, Brizard CP, Alphonso N, Konstantinov IE. Truncus arteriosus repair: a 40\u2010year multicenter perspective. J Thorac Cardiovasc Surg. 2020;813\u2013820.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt213"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.06.018"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00061-2"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.01.087"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.09.046"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.019104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:48:45Z","timestamp":1715600925000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.019104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,17]]},"references-count":20,"journal-issue":{"issue":"22","published-print":{"date-parts":[[2020,11,17]]}},"alternative-id":["10.1161\/JAHA.120.019104"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.019104","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,17]]},"assertion":[{"value":"2020-08-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e019104"}}