Objectives: The purpose of this study was to analyze long term outcome and reoperation after repair of TA. Methods: We performed retrospective review of 27 patients underwent complete repair of TA from April 1982 to January 2008. Median age was 5.0 months. Preoperative truncal valve (TV) insufficiency was absent or trivial in 14 patients, mild in 12 and severe in 1. Reconstruction of the right ventricle to pulmonary artery continuity was performed using an extracardiac valved conduit in 21 patients, REV in 3, non-valved conduit in 3 and repair of regurgitant truncal valve was performed in 4 patients. Results: During the mean follow up of 9.8±7.73 years, there were 2 deaths (7.4%). The Kaplan-Meier estimate of survival was 94.7% at 5 years, 88.0% at 20 years. Among 22 patients who underwent 36 reoperations, 20 underwent 30 reoperations for RV-PA conduit stenosis. Six patients underwent 8 TV reoperations and 12 patients underwent 19 reoperations for pulmonary branch stenosis. Freedom from any reoperation was 88.3%, 41.0% at 1, 5 years, respectively. Freedom from conduit replacement was 88.3%, 20.8% at 1, 8 years, respectively. The methods of RVOT reconstruction (conduit vs REV, valved vs valveless, homemade vs commercial conduit) were not related to conduit related reoperation. Freedom from TV reoperation was 85.4%, 71.2% at 5, 10 years, respectively. Initial TV repair was not a risk factor for TV reoperation (p=0.09) and mortality (p=0.25). But, initial TV regurgitation was a risk factor for TV reoperation (p=0.04) and mortality (p<0.01). At last echocardiography, TV regurgitation was not or trivial in 18 patients, mild in 7 and severe in 2. Conclusions: Repair of TA can be performed with excellent survival but, numerous reoperations for conduit obstruction and pulmonary branch stenosis are required. The methods of RVOT reconstruction were not related to reoperation for conduit stenosis. Initial TV regurgitation was a risk factor for TV reoperation and mortality. The overall long term freedom of TV reoperation rate remains within reasonable ranges.
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