Truncus Arteriosus (TA)
Truncus arteriosus is a heart defect that is present at birth (congenital). It happens
when there is an abnormal connection between the aorta and pulmonary artery . Normally,
the aorta and the pulmonary artery are separate. In truncus arteriosus both the aorta
and pulmonary artery arise from a common blood vessel.
Another congenital heart defect that nearly always happens with this condition is
ventricular septal defect (VSD). This is an abnormal hole in the wall (septum) between
the 2 lower chambers of the heart (right and left ventricles).
truncus arteriosus, oxygen-poor (blue) and oxygen-rich (red) blood mix through the
The mixed blood that goes to the body does not have as much oxygen as it should.
Some congenital heart defects may
occur more often in certain families. These are called genetic defects. Truncus
arteriosus is often seen in babies born with 22q11.2 deletion syndrome. But in most
cases, the cause is not known.
Symptoms of truncus arteriosus include:
color to skin, lips, and nails (cyanosis)
feeding or eating
- Tiredness (fatigue)
- Enlarged liver
symptoms of truncus arteriosus can be like other health conditions. Have your child
their healthcare provider for a diagnosis.
prenatal ultrasound may show truncus arteriosus. After birth, your child's healthcare
provider will check your child. They may find signs like a pounding heart and weak
pulse. They may hear an abnormal heart sound (heart murmur) when listening to your
baby's chest with a stethoscope. If so, you may have been referred to a pediatric
cardiologist for a diagnosis. This is a doctor with special training to diagnose and
treat heart problems in babies and children.
specialists will also examine your baby. They will listen to their heart and lungs
a stethoscope. Your baby may have other tests, including:
A probe placed on your child's finger or toe can measure the oxygen
level. Low levels may mean a diagnosis of truncus arteriosus.
This shows the overall size and shape of the heart and lungs. It may
show signs typical of truncus arteriosus.
Electrocardiogram (ECG). An ECG records the electrical activity of the
heart. It shows abnormal rhythms, and finds heart muscle stress.
Echocardiogram (echo). An echo uses sound waves (ultrasound) to make a
moving picture of the heart and heart valves. An echo shows the truncus
This gives very detailed information about the structures
inside the heart. Your baby will be given medicine to relax (sedation). The
healthcare provider will put a thin, flexible tube (catheter) into a blood vessel
the groin and move it to the heart. They will take measurements of blood pressure
oxygen in the heart chambers. The pulmonary artery and aorta will also be checked.
Contrast dye is also injected to let the provider more clearly see the structures
inside the heart.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
Truncus arteriosus must be treated with surgery to fix the defects. Typically surgery
needs to occur during the first few days or weeks of life. But your child may need
medical support until it is time for the operation to take place. Support may
- Medicines to help the heart pump better.
device (noninvasive positive pressure ventilation) to help make breathing easier.
Some children may need mechanical ventilation.
Nutritional support may include:
Special nutritional supplements. These may be added
to formula or pumped breastmilk to increase calories.
Tube feedings. These are given through a small,
flexible tube that passes through the nose, down the esophagus, and into the
stomach. These feedings may be added to or take the place of bottle-feedings. Infants
who can drink part of their bottles, but not all, may be fed the rest through the
feeding tube. Infants who are too tired to bottle-feed may get their formula or
breastmilk through the feeding tube alone.
Surgery is often done in the first few weeks after birth to prevent lung damage. The
pulmonary arteries are separated from the aorta and reattached to the right ventricle.
The pulmonary arteries may be reattached directly to the right ventricle. Or the surgeon
may use an artificial tube graft to re-attach them. The ventricular septal defect
also closed. Your child will stay in the hospital until after the surgical repair.
not treated, truncus arteriosus may cause complications such as:
- Infection of the lining of the heart and heart valves (bacterial endocarditis)
growth and development
- Diminished ability to function
after surgery, babies have more energy and start to eat better and gain weight faster.
But your baby may need high-calorie formula for several weeks or months after surgery.
Your baby may also need tube feedings until they are able to feed better.
baby may become tired easily, and sleep more right after surgery. But in a few weeks,
they should be fully recovered.
may get other instructions from your child's cardiac team and the hospital staff.
children who have had truncus arteriosus surgical repair will live healthy lives.
activity levels, appetite, and growth will often return to normal. Talk with your
child's cardiologist about what activities and sports are safe for your child.
child most likely will need more surgery as he or she grows. Surgery in young adulthood
may also be needed. These surgeries may involve replacing valves, repairing a narrowed
aorta or pulmonary arteries, or replacing conduits.
cardiologist may advise that your child take antibiotics before surgery or dental
procedures. This is to prevent infection in the lining of the heart and heart valves
child will need regular follow-up care at a pediatric or adult congenital cardiac
center throughout life.
with the cardiologist about your child’s outlook.
When to Call a Healthcare Provider
Call your child's healthcare provider
if your child has trouble breathing or feeding, or develops new symptoms.
arteriosus happens when there is an abnormal connection between the aorta and
causes oxygen-poor (blue) blood and oxygen-rich blood to mix and to be pumped to the
body. This causes blue skin, lips, or nails (cyanosis).
- The low
levels of oxygen may not be enough to meet the body's needs and sustain life.
condition must be treated with surgery. Most children who have surgery will live
child will need regular follow-up care with a pediatric cardiologist.
to help you get the most from a visit to your child’s healthcare provider:
the reason for the visit and what you want to happen.
your visit, write down questions you want answered.
- At the
visit, write down the name of a new diagnosis, and any new medicines, treatments,
tests. Also write down any new instructions your provider gives you for your
- Know why
a new medicine or treatment is prescribed and how it will help your child. Also know
what the side effects are.
- Ask if
your child’s condition can be treated in other ways.
- Know why
a test or procedure is recommended and what the results could mean.
what to expect if your child does not take the medicine or have the test or
- If your
child has a follow-up appointment, write down the date, time, and purpose for that
how you can contact your child’s provider after office hours. This is important if
your child becomes ill and you have questions or need advice.