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Truncus arteriosus

Truncus

Truncus arteriosus is a rare type of heart disease in which a single blood vessel (truncus arteriosus) comes out of the right and left ventricles, instead of the normal 2 vessels (pulmonary artery and aorta). It is present at birth (congenital heart disease).

There are different types of truncus arteriosus.

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Heart - section through the middle
Truncus arteriosus

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Causes

In normal circulation, the pulmonary artery comes out of the right ventricle and the aorta comes out of the left ventricle, which are separate from each other.

With truncus arteriosus, a single artery comes out of the ventricles. There is most often also a large hole between the 2 ventricles (ventricular septal defect). As a result, the blue (without oxygen) and red (oxygen-rich) blood mix.

Some of this mixed blood goes to the lungs, and some goes to the rest of the body. Often, more blood than usual ends up going to the lungs.

If this condition is not treated, two problems occur:

Symptoms

Symptoms include:

Exams and Tests

A murmur is most often heard when listening to the heart with a stethoscope.

Tests include:

Treatment

Surgery is needed to treat this condition. The surgery creates 2 separate arteries.

In most cases, the truncal vessel is kept as the new aorta. A new pulmonary artery is created using tissue from another source or using a man-made tube. The branch pulmonary arteries are sewn to this new artery. The hole between the ventricles is closed.

Outlook (Prognosis)

Complete repair most often provides good results. Another procedure may be needed as the child grows, because the rebuilt pulmonary artery that uses tissue from another source will not grow with the child.

Untreated cases of truncus arteriosus result in death, often during the first year of life.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your health care provider if your infant or child:

If the skin, lips, or nail beds look blue or if the child seems to be very short of breath, take the child to the emergency room or have the child examined promptly.

Prevention

There is no known prevention. Early treatment can often prevent serious complications.

Related Information

Congenital heart disease
Muscle cramps
Ventricular septal defect
Heart failure
Pediatric heart surgery
Pediatric heart surgery - discharge

References

Fraser CD, Kane LC. Congenital heart disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease in the adult and pediatric patient. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 75.

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Review Date: 10/22/2019  

Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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