Common Arterial Trunk (Truncus Arteriosus)
Common arterial trunk, a rare congenital malformation, is characterized by a single arterial trunk that arises from the base of the heart and supplies the systemic, pulmonary, and coronary circulations. The first recorded case of truncus arteriosus was from a well-described autopsy by Wilson in 1798, later reported in a 6-month-old infant by Buchanan in 1864. Today, common arterial trunk is identified in 3 to 10 of 100,000 live births, accounting for 4% of all those born with congenital heart disease. Common arterial trunk can result in significant early mortality in the first year of life and reinterventions for truncal valve insufficiencies later in life. Early perioperative survival, depends mostly on the amount of increased pulmonary vascular resistance, degree of truncal valve insufficiency, and associated cardiac anomalies. The most significant factor responsible for gains in primary repair outcomes is the steady trend toward earlier correction, which provides a patient with reversible pulmonary vascular obstructive disease and preserved myocardial function. The current chapter focuses on embryology, anatomy, physiology, nomenclature and classification, operative techniques, reintervention, and valve durability.
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