User:Mr. Ibrahem/Persistent truncus arteriosus
| Persistent truncus arteriosus | |
|---|---|
| Other names | Common arterial trunk, trunks arterioles communis, common aorticopulmonary trunk[1] patent truncus arteriosus |
 | |
| Illustration of truncus arteriosus | |
| Specialty | Cardiac surgery |
| Symptoms | First few days: Mild bluish skin Later: Poor activity, poor feeding, fast breathing[2] |
| Complications | Heart failure, Eisenmenger syndrome[3] |
| Usual onset | Present at birth[2] |
| Causes | Unknown[3] |
| Risk factors | DiGeorge syndrome[3] |
| Diagnostic method | Ultrasound of the heart[2] |
| Differential diagnosis | Tetralogy of Fallot, tricuspid atresia, total anomalous pulmonary venous return, hypoplastic left heart syndrome, coarctation of the aorta[3] |
| Treatment | Prostaglandin E1, breathing support, furosemide, surgery[4][3] |
| Prognosis | 20 year survival >80% with treatment[3] |
| Frequency | 7 per 100,000 live births[3] |
Persistent truncus arteriosus (PTA) is a congenital heart disease that presents with a common ventricular outflow tract, ventricular septal defect (VSD), and single truncal valve.[2] In the first few days of life there may be no symptoms, with the development of bluish skin over the next few weeks.[2] Without surgery, this is followed by heart failure with poor activity, poor feeding, and fast breathing.[3] Complications may include Eisenmenger syndrome.[3]
The cause is generally unknown, though the condition may be associated with DiGeorge syndrome.[3] The underlying mechanism involves failure of the truncus arteriosus to divide into the pulmonary trunk and aorta during early development.[3] This results in blood from both sides of the heart mixing before it enters the coronary arteries, pulmonary arteries, and systemic circulation.[4][3] One in four cases have significant truncal valve narrowing and back flow of blood.[2] The condition may be suspected based on an ECG showing enlargement of both ventricles, a chest X-ray showing a large heart, and a systolic heart murmur.[4][3] Confirmation is by ultrasound of the heart.[3]
Initial treatment may include prostaglandin E1 and breathing support.[4] If pulmonary edema is present furosemide, CPAP, and avoiding extra oxygen may be recommended.[3] Surgery correction is recommended within the first month of life.[3] About 75% of people require a further operation in their next 10 years of life.[3] Without treatment, around 40% do not survive beyond one month.[2] Around 5% do not survive surgery, but of those that do, survival is 90% at 5 years, 85% at 10-years, and 83% at 15 years.[2]
PTA is rare, affecting about 7 per 100,000 live births.[3] It accounts for around 0.4% to 4% of all heart defects that present at birth.[2] The work "truncus arteriosus" is Latin for single artery.[3] It was first described by James Wilson in 1798.[1]
References[edit]
- ^ a b Chan, Francis P. (2011). "45. Truncus arteriosus". In Ho, Vincent B.; Reddy, Gautham P. (eds.). Cardiovascular Imaging. Vol. 1. St. Louis, Missouri: Saunders, Elsevier. pp. 616–624. ISBN 978-1-4160-5335-4. Archived from the original on 2022-10-13. Retrieved 2021-02-04.
- ^ a b c d e f g h i Sainathan, Sandeep W.; Bayle, Ken-Michael; Knott-Craig, Christopher; Boston, Umar (2020). "98. Truncus arteriosus". In Raja, Shahzad G. (ed.). Cardiac Surgery: A Complete Guide. Switzerland: Springer. pp. 891–895. ISBN 978-3-030-24176-6. Archived from the original on 2022-10-16. Retrieved 2022-10-16.
- ^ a b c d e f g h i j k l m n o p q r s Bhansali, S; Phoon, C (January 2020). "Truncus Arteriosus". PMID 30521195.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c d Barata IA (August 2013). "Cardiac emergencies". Emergency Medicine Clinics of North America. 31 (3): 677–704. doi:10.1016/j.emc.2013.04.007. PMID 23915599.