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Definition

Truncus arteriosus is a defect in the large blood vessels that leave the heart.

Normally, two large blood vessels, called the aorta and pulmonary artery carry blood away from the heart. The aorta carries oxygen-rich blood from the heart to the rest of the body. The pulmonary artery carries oxygen-poor blood from the heart to the lungs. As the heart develops. a section of these two blood vessels sometimes combine together. It creates one large vessel called the truncus arteriosus. The oxygen-poor and oxygen-rich blood leaving the heart mix in this combined blood vessel. The mixed blood decreases the amount of oxygen-rich blood that reaches the body.

The defect also includes a large hole in the wall between the lower chambers of the heart.

Heart Chambers and Valves

heart anatomy

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Blood Flow Through the Heart


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Causes

Truncus arteriosus is a problem with the development of the heart while the baby is in the womb. It is not known exactly why some hearts develop this way.

Risk Factors

Factors that may increase the risk for congenital heart disease may include:

  • Chromosomal disorders such as Down syndrome or DiGeorge syndrome
  • Conditions during pregnancy, such as:
    • Viral infection such as rubella
    • Poorly controlled diabetes
    • Alcohol consumption
    • Smoking
    • Taking certain medicines such as thalidomide
Symptoms

Low oxygen levels in the body may cause symptoms such as:

  • Blue or pale grayish skin color
  • Fast breathing
  • High blood pressure
  • Irritability
  • Poor feeding/poor weight gain

The doctor may also detect a fast heart rate during the exam.

Diagnosis

Your doctor may suspect a heart problem based on your child's symptoms and heart rate. Blood tests and oxygen saturation tests may be done to assess the levels of oxygen in your child's blood. To confirm the diagnosis and create images of the heart, your doctor may order:

Treatment

Early treatment is important to help prevent complications such as heart failure . Treatment options may include:

Surgery

Surgery is usually done right away, during infancy. The type of surgery depends on how severe the defect is. The goals are to improve circulation, which may be done by:

  • Creating a new pulmonary artery to carry blood to the lungs
  • Creating a new aorta to carry blood to the rest of the body
  • Closing the hole in the wall between the lower chambers of the heart

Other surgeries may be needed as your child grows.

Medication

Medications may be given to help support your child's heart before surgery. Medication may be given to:

  • Decrease fluid retention to lower workload on the heart
  • Improve heart function

After surgery, your child may need antibiotics before certain medical or dental procedures. This is to prevent an infection in the heart.

Lifelong Monitoring

Your child will have regular exams from a heart specialist.

Prevention

It is not always possible to prevent heart defects since the cause is not clear. You can reduce the risk of heart defects by practicing good prenatal care such as:

  • Regular doctor visits to monitor your health and the health of the baby.
  • Eat nutritious food and take prenatal vitamins
  • Avoid alcohol, smoking , or use drug use during pregnancy
  • Practicing good hygiene and staying away from people who are sick

RESOURCES:

American Family Physician
http://www.aafp.org/

American Heart Association
http://www.americanheart.org/

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca/

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/

References:

Truncus arteriosus. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Truncus-Arteriosus_UCM_307040_Article.jsp . Accessed June 21, 2013.

Truncus arteriosus. EBSCO DynaMed website. Available at:  http://www.ebscohost.com/dynamed/what.php . Updated March 29, 2012. Accessed June 21, 2013.

Truncus arteriosus. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=truncusarteriosus1 . Accessed June 21, 2013.



Last reviewed June 2013 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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