User:Mr. Ibrahem/Persistent truncus arteriosus

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. In the first few days of life there may be no symptoms, with the development of bluish skin over the next few weeks. Without surgery, this is followed by heart failure with poor activity, poor feeding, and fast breathing. Complications may include Eisenmenger syndrome.

The cause is generally unknown, though the condition may be associated with DiGeorge syndrome. The underlying mechanism involves failure of the truncus arteriosus to divide into the pulmonary trunk and aorta during early development. This results in blood from both sides of the heart mixing before it enters the coronary arteries, pulmonary arteries, and systemic circulation. One in four cases have significant truncal valve narrowing and back flow of blood. 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. Confirmation is by ultrasound of the heart.

Initial treatment may include prostaglandin E1 and breathing support. If pulmonary edema is present furosemide, CPAP, and avoiding extra oxygen may be recommended. Surgery correction is recommended within the first month of life. About 75% of people require a further operation in their next 10 years of life. Without treatment, around 40% do not survive beyond one month. 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.

PTA is rare, affecting about 7 per 100,000 live births. It accounts for around 0.4% to 4% of all heart defects that present at birth. The work "truncus arteriosus" is Latin for single artery. It was first described by James Wilson in 1798.