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Truncus arteriosus
Truncus
Truncus arteriosus is a rare type of heart disease that 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 ).
Congenital heart disease
Congenital heart disease (CHD) is a problem with the heart's structure and function that is present at birth.
There are different types of truncus arteriosus.
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.
Ventricular septal defect
Ventricular septal defect is a hole in the wall that separates the right and left ventricles of the heart. Ventricular septal defect is one of the m...
Some of this mixed blood goes to the lungs, and some goes to the rest goes of the body. Often, more blood than usual ends up going to the lungs.
If this condition is not treated, 2 problems occur:
- Too much blood circulation in the lungs may cause extra fluid to build up in and around them. This makes it hard to breathe.
-
If left untreated and more than normal blood flows to the lungs for a long time, the blood vessels to the lungs become permanently damaged. Over time, it becomes very hard for the heart to force blood to them. This is called
pulmonary hypertension
, which can be life threatening.
Pulmonary hypertension
Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal.
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Symptoms
Symptoms include:
-
Bluish skin (cyanosis)
Bluish skin (cyanosis)
Cyanosis is a bluish color to the skin or mucous membrane that is usually due to a lack of oxygen in the blood.
ImageRead Article Now Book Mark Article - Delayed growth or growth failure
- Fatigue
- Lethargy
- Poor feeding
- Rapid breathing (tachypnea)
- Shortness of breath (dyspnea)
- Widening of the finger tips (clubbing)
Exams and Tests
A murmur is most often heard when listening to the heart with a stethoscope.
Tests include:
-
ECG
ECG
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
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Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Cardiac catheterization
Cardiac catheterization
Cardiac catheterization involves passing a thin flexible tube (catheter) into the right or left side of the heart. The catheter is most often insert...
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MRI of the heart
MRI of the heart
Heart magnetic resonance imaging is an imaging method that uses powerful magnets and radio waves to create pictures of the heart. It does not use ra...
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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:
-
Heart failure
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
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When to Contact a Medical Professional
Call your health care provider if your infant or child:
- Appears lethargic
- Appears overly tired or mildly short of breath
- Does not eat well
- Does not seem to be growing or developing normally
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.
References
Fraser CD, Carberry KE. Congenital heart disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 59.
Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 62.
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Heart, section through the middle - illustration
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart, section through the middle
illustration
-
Truncus arteriosus - illustration
Normally the aorta arises from the left ventricle and the pulmonary artery arises from the right ventricle. In truncus arteriosus both vessels are combined into one vessel. A hole between the two ventricles is usually also present. As a result, unoxygenated and oxygenated blood mix completely. This causes too much blood to be sent to the lungs and not enough oxygentated blood to get to the heart and the rest of the body.
Truncus arteriosus
illustration
-
Heart, section through the middle - illustration
The interior of the heart is composed of valves, chambers, and associated vessels.
Heart, section through the middle
illustration
-
Truncus arteriosus - illustration
Normally the aorta arises from the left ventricle and the pulmonary artery arises from the right ventricle. In truncus arteriosus both vessels are combined into one vessel. A hole between the two ventricles is usually also present. As a result, unoxygenated and oxygenated blood mix completely. This causes too much blood to be sent to the lungs and not enough oxygentated blood to get to the heart and the rest of the body.
Truncus arteriosus
illustration
Review Date: 10/22/2015
Reviewed By: Larry A. Weinrauch, MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
