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Truncus Arteriosus

  • Sandeep Sainathan
  • Ken-Michael Bayle
  • Christopher J. Knott-Craig
  • Umar S. BostonEmail author
Chapter
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Abstract

Truncus arteriosus is a rare congenital cardiac lesion characterized by failure of embryonic truncal septation resulting in a single semilunar valve and single arterial trunk providing both pulmonary and systemic circulations. Systemic venous blood and pulmonary venous blood mix at the ventricular septal defect level, and the resulting desaturated blood is ejected into the single outflow tract. Because the pulmonary arteries arise directly from the truncus, the pulmonary vascular resistance will determine the pulmonary blood flow, which is usually torrential. Without surgical intervention, death in infancy is the rule. Surgery for truncus arteriosus has evolved over the past 50 years. Current management involves total repair during the neonatal period with excellent expected results. The presence of truncal valve insufficiency or interrupted aortic arch may increase the surgical risk for morbidity and mortality. Current therapy and management continue to evolve. This chapter will focus on the morphology, pathophysiology, and management of truncus arteriosus.

Keywords

Common arterial trunk Cyanotic congenital heart disease Monocusp valve Truncal valve Truncus arteriosus 

References

  1. 1.
    Lev M, Saphir O. Truncus arteriosus communis persistens. J Pediatr. 1942;20:74–88.CrossRefGoogle Scholar
  2. 2.
    Bove EL, Lupinetti FM, Pridjian AK, et al. Results of a policy of primary repair of truncus arteriosus in the neonate. J Thorac Cardiovasc Surg. 1993;105:1057–65.CrossRefGoogle Scholar
  3. 3.
    Mello DM, McElhinney DB, Parry AJ, Silverman NH, Hanley FL. Truncus arteriosus with patent ductus arteriosus and normal aortic arch. Ann Thorac Surg. 1997;64:1808–10.CrossRefGoogle Scholar
  4. 4.
    Mittal K, Dey AK, Gadewar R, et al. Rare case of truncus arteriosus with anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) and unilateral left pulmonary artery agenesis. Jpn J Radiol. 2015;33:220–4.CrossRefGoogle Scholar
  5. 5.
    McElhinney DB, Driscoll DA, Emanuel BS, Goldmuntz E. Chromosome 22q11 deletion in patients with truncus arteriosus. Pediatr Cardiol. 2003;24:569–73.CrossRefGoogle Scholar
  6. 6.
    Russell HM, Jacobs ML, Anderson RH, et al. A simplified categorization for common arterial trunk. J Thorac Cardiovasc Surg. 2011;141:645–53.CrossRefGoogle Scholar
  7. 7.
    Behrendt DM, Kirsh MM, Stern A, Sigmann J, Perry B, Sloan H. The surgical therapy for pulmonary artery—right ventricular discontinuity. Ann Thorac Surg. 1974;18:122–37.CrossRefGoogle Scholar
  8. 8.
    Barbero-Marcial M, Riso A, Atik E, Jatene A. A technique for correction of truncus arteriosus types I and II without extracardiac conduits. J Thorac Cardiovasc Surg. 1990;99:364–9.CrossRefGoogle Scholar
  9. 9.
    Alfieris GM, Swartz MF. Technique for the repair of truncus arteriosus to maintain pulmonary artery architecture. Oper Tech Thorac Cardiovasc Surg. 2011;16:191–204.CrossRefGoogle Scholar
  10. 10.
    Russell HM, Pasquali SM, Jacobs JP, et al. Outcomes of repair of common arterial trunk with truncal valve surgery: a review of The Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2012;93:164–9.CrossRefGoogle Scholar
  11. 11.
    Patrick WL, Mainwaring RD, Carrillo SA, et al. Anatomic factors associated with truncal valve insufficiency and the need for truncal valve repair. World J Pediatr Congenit Heart Surg. 2016;7:9–15.CrossRefGoogle Scholar
  12. 12.
    Henaine R, Azarnoush K, Belli E, et al. Fate of the truncal valve in truncus arteriosus. Ann Thorac Surg. 2008;85:172–8.CrossRefGoogle Scholar
  13. 13.
    Mavroudis C, Backer CL. Surgical management of severe truncal insufficiency: experience with truncal valve remodeling techniques. Ann Thorac Surg. 2001;72:396–400.CrossRefGoogle Scholar
  14. 14.
    Rajasinghe HA, McElhinney DB, Reddy VM, Mora BN, Hanley FL. Long-term follow-up of truncus arteriosus repaired in infancy: a twenty-year experience. J Thorac Cardiovasc Surg. 1997;113:869–79.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Sandeep Sainathan
    • 1
  • Ken-Michael Bayle
    • 2
  • Christopher J. Knott-Craig
    • 1
  • Umar S. Boston
    • 1
    Email author
  1. 1.Division of Pediatric Cardiothoracic Surgery, Department of Surgery, University of Tennessee Health Science CenterLe Bonheur Children’s HospitalMemphisUSA
  2. 2.Division of Pediatric Cardiology, University of Tennessee Health Science CenterLe Bonheur Children’s HospitalMemphisUSA

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