A technique for type II truncus repair without a conduit has been described. The truncal root is transected. The confluence of the branch PAs is brought anterior to the aorta and anastomosed directly to the right ventriculotomy. Mild truncal valve insufficiency may resolve with closure of the truncal defect after removal of the PAs. Moderate insufficiency may be amenable to resuspension of the valve leaflets and commisural annuloplasty .
Severe dysfunction requires valve replacement.
The truncal root also can be replaced by a second valved homograft .