Truncus arteriosus Type ii
AbstractBackground : Truncus arteriosus (TA) is an uncommon congenital cardiovascular anomaly that is characterized by a single arterial trunk arising from the normally formed ventricles by means of a single semilunar valve (ie, truncal valve).
Case presentation : A 3-month-old female infant product of spontaneous vaginal delivery complaining from dyspnea , tachypnea , mild cyanosis since birth , decrease in feeding and activity ,She was admitted twice in different hospitals and diagnose as a case of VSD with pulmonary hypertention , given treatment but no response , the family picked her to Babylon for maternity and children hospital . ECHO and cardiac CT- angiography was done were revealed truncus arteriosus.
She was treated by anti failure and drug which lower pulmonary vascular resistance, her condition improve and become stable . after that they went to turkey where operation was done in specialized cardiac centre before age of six month.
Conclusion : In any infant with signs and symptoms of congestive heart failure and mild cyanosis truncus arteriosus shoud be suspected.
Corrective operation should be done in first six month of age
Truncus arteriosus (TA) is a rare cardiac disorder,(1)account of about (0.7%-1.4%) of all congenital heart disease, in which aorta and pulmonary artery were not separated completely during fetal development and both originate jointly from left ventricle(2). It has an incidence of about 0.3/10,000 live birth,no striking sex difference although most series contain male more than female.(3,4..
Etiology is multifactorial and it may be associated with microdeletion chromosome 22q11.2, maternal diabetes has been implicated as a risk factor for truncus arteriosus.(5)
The number of truncal valve cusps varies from 2 to as many as 6 and the valve may stenotic,regurgitant, or both(6). Its had been classified by Collet and Edwards in 4 different types in 1949.
Type I in which the pulmonary arteries can arise together from the posterior left side of the persistent truncus arteriosus and then divided into left and right pulmonary
arteries, in type II and III, no main pulmonary artery is present, and the right and left pulmonary arteries arise from separated orifice on posterior(type II) or lateral (type III) aspect of truncus arteriosus. Type IV truncus is a term
no longer used, this essentially a form of pulmonary atresia.(6)
During past 20 years, diagnostic and therapeutic methods along with immediate intervention for surgery in infancy with complete reparation of VSD lead to evident improvement and less morbidity in newborns. Truncus arteriosus canbe diagnosed in utero by fetal echocardiography.(7)