Improving surgical techniques has led to the long-term survival of these patients. Surgical intervention is required to avoid pulmonary vascular disease that would likely ensue in the unrepaired patient. Newborns often present with signs of florid heart failure and cyanosis. The prognosis of patients with TA lesions is poor without surgical intervention. Other common associated anomalies include a right aortic arch with mirror-image branching of the brachiocephalic vessels, aberrant subclavian artery, persistent left superior vena cava to coronary sinus, and secundum-type atrial septal defect. The most common extracardiac anomaly associated with IAA is DiGeorge syndrome. Interruption of the aortic arch in TA is often accompanied by ductal continuity of the descending thoracic aorta when present. Interruption of the aortic arch usually is defined as either type A, B or type C according to the location of discontinuity in the aortic arch. Interruption of the aortic arch (IAA) is found in approximately 11-19% of children with TA lesions. This form (Type IV) is no longer considered within the spectrum of TA, as it is thought to represent a variation of pulmonary atresia with VSD. Finally, Type IV truncus is defined by the absence of pulmonary arteries and alternatively, the lungs are supplied by aortopulmonary collaterals. Type III truncus also has no main pulmonary trunk and the right and left pulmonary arteries aries distant from one another (6-10% of cases). Type II truncus is defined by the absence of a main pulmonary trunk but the left and right pulmonary vessels arise close to one another (29-48% of cases). A Type I truncus is defined by a short main pulmonary trunk that arises from the common arterial trunk and then divides into right and left pulmonary arteries (48-68% of cases). Most commonly, patients with common trunk anomalies have a large, nonrestrictive, subarterial ventricular septal defect (VSD) situated below the truncal valve.Ĭollette and Edwards described four types of TA lesions based on the origin of the pulmonary arteries. The truncal valve is most commonly tricuspid (70% of cases), but can be quadricuspid (21%) or bicuspid (9%) as well occasionally more than 4 truncal leaflets have also been reported. Truncus arteriosus is defined as a single arterial vessel usually arising from both the left and the right ventricle that gives rise to the systemic, pulmonary and coronary artery circulations. Truncus arteriosus communis (TA) or common arterial trunk is an uncommon congenital cardiac malformation accounting for approximately 0.7% of all complex congenital heart lesions.
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