Materiały źródłowe

• #1 Surgical repair for persistent truncus arteriosus in neonates and older children | Journal of Cardiothoracic Surgery | Full Text

  https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-020-01114-1

  Persistent truncus arteriosus represents less than 3% of all congenital heart defects. The treatment of choice of TA, during the neonatal period, in the current era is primary repair. This involves separating the pulmonary and systemic pathways through the establishment of a right ventricle to pulmonary artery connection along with VSD closure. Repair of the truncus arteriosus can be performed safely with low morbidity and mortality, both in neonates, infants, and older children. Re-intervention is common, preferably through a transcatheter approach. […] Without surgical intervention, 80% of these patients die within the first year of life, mainly during early infancy. […] Complete one stage repair is the treatment of choice for TA and should be performed early within the first few months of life. […] Reoperation is common after TA repair, and the freedom from the reoperation in our series was 65% at 3 years.

• #2 Truncus arteriosus | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/truncus-arteriosus?lang=us

  Due to the parallel nature of fetal circulation, truncus arteriosus does not result in significant hemodynamic disturbances in utero. However, after birth, when separate pulmonary and systemic circulations are required, this congenital heart defect becomes a critical issue. Without prompt surgical correction, approximately 70-85% of affected infants die within the first year, primarily due to complications such as congestive heart failure and pulmonary vascular disease.

• #3 Truncus arteriosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/truncus-arteriosus/diagnosis-treatment/drc-20364277

  Infants with truncus arteriosus need surgery to improve blood flow and oxygen levels. Many procedures or surgeries might be needed, especially as a child grows. Medicines might be given before surgery to help improve heart health. […] Children and adults with surgically repaired truncus arteriosus need regular health checkups for life. […] Most infants with truncus arteriosus have surgery within the first few weeks after birth. The specific type of surgery depends on the baby’s condition. Usually, the baby’s surgeon: […] After surgery for truncus arteriosus, a person needs lifelong follow-up care with a heart doctor specializing in congenital disease. This type of healthcare professional is called a congenital cardiologist.

• #4 Truncus arteriosus | Causes, symptoms, diagnosis | Children’s Wisconsin

  https://childrenswi.org/medical-care/herma-heart/conditions/truncus-arteriosus

  Truncus arteriosus must be treated by surgical repair of the defects. However, medical support may be necessary until the best time for the operation to take place. Treatment may include: […] Surgery is usually performed after the infant is 2 weeks old, but before the blood vessels in the lungs are overwhelmed by extra blood flow and become diseased. The operation is performed under general anesthesia, and involves the following: […] Specific treatment for truncus arteriosus will be determined by your child’s physician based on: […] Many children will eventually need to take medications to help the heart and lungs work better. Medication that may be prescribed includes the following: […] Adequate nutrition – Infants may become tired when feeding, and may not be able to eat enough calories to gain weight. Options that can be used to ensure your baby will have adequate nutrition include: […] Surgical repair – Surgery is usually performed after the infant is 2 weeks old, but before the blood vessels in the lungs are overwhelmed by extra blood flow and become diseased. The operation is performed under general anesthesia, and involves the following:

• #5 Truncus Arteriosus – Children’s Hospital of Orange County

  https://choc.org/heart/congenital-heart-defects/truncus-arteriosus/

  Specific treatment for truncus arteriosus is determined by the child’s healthcare team. Truncus arteriosus must be treated by surgical repair of the defects. However, medical support may be necessary until the best time for the operation to take place. Treatment may include: […] Surgery is usually done within the first few weeks after birth, before the blood vessels in the lungs are overwhelmed by extra blood flow and become damaged. The operation is done under general anesthesia, and involves the following: – The pulmonary arteries are detached from the common artery (truncus arteriosus) and connected to the right ventricle using a homograft (a section of pulmonary artery with its valves intact from a tissue donor). Occasionally, a conduit (a small tube containing a valve) is used instead of a homograft (human tissue valve). – The ventricular septal defect is closed with a patch. […] Learn more about heart surgery at CHOC.

• #6 Truncus Arteriosus | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/truncus-arteriosus

  Initial treatment begins with stabilizing the infant. Medications to control congestive heart failure are often started. […] Surgery is typically done in the first few weeks of life after the infant is stabilized. […] The surgical repair of truncus arteriosus uses the heart-lung bypass machine for support. It involves three major parts: Separating the pulmonary arteries from the main truncus, Closing the ventricular septal defect using a patch, Creating a connection between the right ventricle and the pulmonary arteries using a conduit (an artificial tube). […] Infants will need to be watched closely in the Cardiac Intensive Care Unit while they recover. […] Time in the hospital after surgery ranges from one to three weeks in most cases. […] As the child grows, he or she will be followed by a cardiologist. They will need echocardiograms and EKGs.

• #7 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Medical care before surgical repair depends on the neonate’s clinical presentation. […] Most neonates with truncus arteriosus display evidence of congestive heart failure and are usually treated with digitalis and diuretic medicines. […] Intravenous prostaglandin is often administered in patients with truncus arteriosus upon presentation because the differential diagnosis includes numerous anomalies with duct-dependent systemic or pulmonary blood flow. However, it is beneficial only in patients with associated interruption of the aortic arch or aortic coarctation. […] Other preoperative medications are not generally indicated, although specific circumstances may dictate afterload reducing agents, inotropic medications, or antiarrhythmics. […] Surgical management of truncus arteriosus has undergone significant evolution over the past 30 years. Complete repair was first performed in 1967, but until neonatal and early infant repair became routine in the 1980s, palliative pulmonary artery banding was common, with complete repair performed at an older age. At most centers, primary complete repair in the neonate and young infant has become the accepted standard.

• #8 Truncus Arteriosus

  https://scts.org/patients/congenital/procedures/36/truncus_arteriosus/

  Untreated, truncus arteriosus can be fatal. Surgery to repair truncus arteriosus is generally successful, especially if the repair occurs before your baby is 1 month old. […] Infants with truncus arteriosus must have surgery. Multiple procedures or surgeries might be necessary, especially as your child grows. Medications might be given before surgery to help improve heart health. […] Medications that might be prescribed before surgery include: Diuretics. Often called water pills, diuretics increase the frequency and volume of urination, preventing fluid from collecting in the body, which is a common effect of heart failure. Inotropic agents. This type of medication strengthens the heart’s contractions. […] Most infants with truncus arteriosus have surgery within the first few weeks after birth. The procedure will depend on your baby’s condition. Most commonly your baby’s surgeon will: Close the hole between the two ventricles with a patch, Separate the upper portion of the pulmonary artery from the single large vessel, Implant a tube and valve to connect the right ventricle with the upper portion of the pulmonary artery creating a new, complete pulmonary artery, Reconstruct the single large vessel and aorta to create a new, complete aorta.

• #9 Truncus Arteriosus Medication: Inotropic agents, Diuretic agents, Cardiac glycoside, antiarrhythmic, ACE inhibitor, afterload reducing agent

  https://emedicine.medscape.com/article/892489-medication

  These medications are used to mobilize edema in the early postoperative period and facilitate fluid homeostasis. They are also used for treatment of hypertension. […] These agents are used to increase myocardial contractility, to slow atrioventricular node conduction time, and to potentiate the effects of furosemide. […] These agents are used to decrease systemic vascular resistance, which is beneficial in patients with hypertension, impaired ventricular function, or aortic/truncal valve regurgitation.

• #10 Truncus Arteriosus Medication: Inotropic agents, Diuretic agents, Cardiac glycoside, antiarrhythmic, ACE inhibitor, afterload reducing agent

  https://emedicine.medscape.com/article/892489-medication

  These medications are used to mobilize edema in the early postoperative period and facilitate fluid homeostasis. They are also used for treatment of hypertension. […] These agents are used to increase myocardial contractility, to slow atrioventricular node conduction time, and to potentiate the effects of furosemide. […] These agents are used to decrease systemic vascular resistance, which is beneficial in patients with hypertension, impaired ventricular function, or aortic/truncal valve regurgitation.

• #11 Truncus Arteriosus Treatment in Delhi, India | Symptoms & Causes

  https://www.maxhealthcare.in/our-specialities/paediatric-cardiology/conditions-treatments/truncus-arteriosus

  Some of the medications that may be necessary for the child includes: […] Diuretics prevent fluid from building in the body by increasing the frequency and volume of urination. […] Angiotensin-converting enzyme inhibitors make it easier for the heart to pump blood. […] Decongestants to help strengthen the heart muscle.

• #12 Persistent Truncus Arteriosus – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/persistent-truncus-arteriosus

  Medical treatment of heart failure (eg, diuretics, digoxin, angiotensin-converting enzyme inhibitors) before surgery […] Surgical repair […] Heart failure is treated vigorously with diuretics, digoxin, and angiotensin-converting enzyme (ACE) inhibitors, followed by early surgical repair. Prostaglandin infusion is beneficial to maintain ductal patency when there is interruption or coarctation of the aortic arch, in which case right-to-left shunt through the ductus provides systemic blood flow. […] Surgical management consists of repair during the neonatal period. The ventricular septal defect is closed so that the left ventricle ejects into the truncal root. […] When a conduit is placed during early infancy, its size becomes inadequate as children grow, and the conduit must be revised during childhood.

• #13 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Medical care before surgical repair depends on the neonate’s clinical presentation. […] Most neonates with truncus arteriosus display evidence of congestive heart failure and are usually treated with digitalis and diuretic medicines. […] Intravenous prostaglandin is often administered in patients with truncus arteriosus upon presentation because the differential diagnosis includes numerous anomalies with duct-dependent systemic or pulmonary blood flow. However, it is beneficial only in patients with associated interruption of the aortic arch or aortic coarctation. […] Other preoperative medications are not generally indicated, although specific circumstances may dictate afterload reducing agents, inotropic medications, or antiarrhythmics. […] Surgical management of truncus arteriosus has undergone significant evolution over the past 30 years. Complete repair was first performed in 1967, but until neonatal and early infant repair became routine in the 1980s, palliative pulmonary artery banding was common, with complete repair performed at an older age. At most centers, primary complete repair in the neonate and young infant has become the accepted standard.

• #14 Truncus Arteriosus | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30641

  The initial management involves stabilizing the patient and balancing blood flow through the pulmonary and systemic circuits. Interventions should maintain stable ductal patency in patients with interrupted aortic arch. Care is typically provided in a neonatal (NICU) or cardiac intensive care unit (CICU). […] Loop and thiazide diuretics are used to help achieve proper fluid balance. These treatments reduce excess volume, filling pressure, and pulmonary congestion to improve left ventricle failure. These diuretics also improve right ventricle failure by maintaining control of systemic venous congestion. […] Prostaglandins promote ductal patency if a concurrent aortic arch anomaly exists. Maintaining ductal patency is crucial for ensuring adequate systemic blood flow. […] Definitive surgical correction may be performed as a single-stage repair within the 1st month of life. The procedure is indicated for truncus arteriosus without truncal valve or aortic arch abnormality. Pulmonary artery mobilization from the truncus to the right ventricle, conduit-based right ventricular outflow tract reconstruction, and VSD patch closure are performed within the same operation. Aortic arch abnormalities and the truncal valve are also fixed.

• #15 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Medical care before surgical repair depends on the neonate’s clinical presentation. […] Most neonates with truncus arteriosus display evidence of congestive heart failure and are usually treated with digitalis and diuretic medicines. […] Intravenous prostaglandin is often administered in patients with truncus arteriosus upon presentation because the differential diagnosis includes numerous anomalies with duct-dependent systemic or pulmonary blood flow. However, it is beneficial only in patients with associated interruption of the aortic arch or aortic coarctation. […] Other preoperative medications are not generally indicated, although specific circumstances may dictate afterload reducing agents, inotropic medications, or antiarrhythmics. […] Surgical management of truncus arteriosus has undergone significant evolution over the past 30 years. Complete repair was first performed in 1967, but until neonatal and early infant repair became routine in the 1980s, palliative pulmonary artery banding was common, with complete repair performed at an older age. At most centers, primary complete repair in the neonate and young infant has become the accepted standard.

• #16 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  Recent improvements in cardiopulmonary bypass (CPB), surgical techniques, prenatal diagnosis, and perioperative management have reduced mortality for truncus arteriosus, which has an early mortality rate of 3% to 20% and long-term survival of approximately 75% at 20 years. […] In the current era, early single-staged surgical correction of the truncal defect and its associated pathologies is recommended. […] As survival for patients with truncus arteriosus continues to improve, the importance of tailored management, such as adequate repair with meticulous surgery and vigilant perioperative monitoring, cannot be overemphasized for successful outcomes, particularly in high-risk patients such as those with prematurity, genetic anomalies, extracardiac problems, very low weight, preoperative shock, truncal valve dysfunction, and arch anomaly.

• #17 Truncus Arteriosus | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/truncus-arteriosus

  Initial treatment begins with stabilizing the infant. Medications to control congestive heart failure are often started. […] Surgery is typically done in the first few weeks of life after the infant is stabilized. […] The surgical repair of truncus arteriosus uses the heart-lung bypass machine for support. It involves three major parts: Separating the pulmonary arteries from the main truncus, Closing the ventricular septal defect using a patch, Creating a connection between the right ventricle and the pulmonary arteries using a conduit (an artificial tube). […] Infants will need to be watched closely in the Cardiac Intensive Care Unit while they recover. […] Time in the hospital after surgery ranges from one to three weeks in most cases. […] As the child grows, he or she will be followed by a cardiologist. They will need echocardiograms and EKGs.

• #18 Truncus Arteriosus | Treatment | UK Healthcare

  https://ukhealthcare.uky.edu/gill-heart-vascular-institute/conditions/adult-congenital-heart-disease/truncus-arteriosus/treatment

  Surgical repair of truncal arteriosus is typically performed in the first few weeks or months of life to prevent complications and improve the babys overall health and well-being. […] This repair involves three steps: […] Separating the aorta and pulmonary artery: The primary goal of the surgery is to separate the single large vessel that arises from the heart (truncus arteriosus) into two separate vessels: the aorta and the pulmonary artery. This separation properly distributes oxygen-rich blood to the body and oxygen-poor blood to the lungs. […] Ventricular septal defect (VSD) repair: In most cases of truncus arteriosus, there is also a ventricular septal defect, which is closed. Closing the ventricular septal defect prevents blood from mixing between the right and left ventricles.

• #19 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=90&contentid=P01826

  Treatment will depend on your childs 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 include: […] 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 typically using a conduit. The ventricular septal defect is also closed. Your child will stay in the hospital until after the surgical repair. […] The condition must be treated with surgery. Most children who have surgery will live healthy lives. […] Your child will need regular follow-up care with a pediatric cardiologist.

• #20 Truncus Arteriosus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus

  Babies with truncus arteriosus need heart surgery within the first weeks of life. The most common procedure is called a Rastelli repair, which creates two separate paths for blood to leave your babys heart. […] Your babys surgeon will: […] Use a patch to close the hole in your babys heart (VSD) […] Create a new aorta using the existing blood vessel (truncus) […] Create a new aortic valve using the existing truncal valve […] Place an artificial tube (conduit) and artificial valve to create a new pulmonary artery and valve. […] These are the basic steps for repairing truncus arteriosus. Your babys surgery may include other steps if they have other heart defects that need repair. Your babys surgeon will explain exactly whats necessary for their unique heart anatomy. […] Down the road, your child will need more surgeries to keep their heart and blood vessels working normally.

• #21 FloridaHealthFinder | Truncus arteriosus | Health Encyclopedia | FloridaHealthFinder

  https://quality.dev.healthfinder.fl.gov/health-encyclopedia/HIE/1/001111

  Surgery is needed to treat this condition. The surgery creates 2 separate arteries. […] In most cases, the truncal vessel is kept as the new aorta. A new pulmonary artery is created using tissue from another source or using a man-made tube. The branch pulmonary arteries are sewn to this new artery. The hole between the ventricles is closed.

• #22 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Surgery is needed to close the ventricular septal defect (VSD) and separate blood flow to the body from blood flow to the lungs. This is usually done early in infancy to prevent high blood pressure from damaging the lung arteries. A patch is used to close the ventricular defect. The pulmonary arteries are then disconnected from the single great vessel (the truncus) and a tube (a conduit or tunnel) is placed from the right ventricle to the pulmonary arteries. This is sometimes called a Rastelli repair. […] The conduit connecting the right ventricle to the pulmonary artery conduit may become narrowed and blocked (stenotic) over time, or the child may outgrow the conduit. It may have to be replaced from time to time. Timing of the replacement varies. The peripheral pulmonary arteries also may become narrowed and require treatment. Sometimes conduits and peripheral pulmonary artery narrowings may be dilated using a balloon-tipped catheter or an expandable stent in the cardiac catheterization laboratory. This procedure may help extend the time between operations for conduit changes. Sometimes surgery is required to enlarge the narrowed area. Your child’s cardiologist will discuss whether a balloon/stent procedure or surgery is best.

• #23 Truncus arteriosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/truncus-arteriosus/diagnosis-treatment/drc-20364277

  Infants with truncus arteriosus need surgery to improve blood flow and oxygen levels. Many procedures or surgeries might be needed, especially as a child grows. Medicines might be given before surgery to help improve heart health. […] Children and adults with surgically repaired truncus arteriosus need regular health checkups for life. […] Most infants with truncus arteriosus have surgery within the first few weeks after birth. The specific type of surgery depends on the baby’s condition. Usually, the baby’s surgeon: […] After surgery for truncus arteriosus, a person needs lifelong follow-up care with a heart doctor specializing in congenital disease. This type of healthcare professional is called a congenital cardiologist.

• #24 Partners in Care | Truncus Arteriosus treatment at the Texas Center…

  https://www.partnersincare.health/conditions/truncus-arteriosus

  Treatment of truncus arteriosus requires open-heart surgery, usually shortly after birth. During surgery, the pulmonary arteries will be separated from the trunk and connected to the pulmonary arteries to the right pumping chamber (ventricle) of the heart using tubes or conduits. The trunk is repaired so that it becomes a separate functioning aorta or main body artery. If the baby also has a ventricular septal defect, this is typically closed by placing a patch over the hole during the same operation.

• #25 Truncus Arteriosus Repair

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/tests-procedures/truncus-arteriosus-repair/

  To address TA, open-heart surgery (involves dividing the breast bone / general anesthesia) will be performed within the first 2 weeks of your babys life. […] The operation uses a conduit which is a tube made of either Dacron with a pig valve inside it or a donated human valve and artery (called a homograft valve). One end of the conduit/homograft is sewn into the right ventricle and the other end is sewn into the pulmonary artery. […] Most children with truncus arteriosus will need their conduit/homograft replaced two to three times before they reach adulthood.

• #26 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Surgery is needed to close the ventricular septal defect (VSD) and separate blood flow to the body from blood flow to the lungs. This is usually done early in infancy to prevent high blood pressure from damaging the lung arteries. A patch is used to close the ventricular defect. The pulmonary arteries are then disconnected from the single great vessel (the truncus) and a tube (a conduit or tunnel) is placed from the right ventricle to the pulmonary arteries. This is sometimes called a Rastelli repair. […] The conduit connecting the right ventricle to the pulmonary artery conduit may become narrowed and blocked (stenotic) over time, or the child may outgrow the conduit. It may have to be replaced from time to time. Timing of the replacement varies. The peripheral pulmonary arteries also may become narrowed and require treatment. Sometimes conduits and peripheral pulmonary artery narrowings may be dilated using a balloon-tipped catheter or an expandable stent in the cardiac catheterization laboratory. This procedure may help extend the time between operations for conduit changes. Sometimes surgery is required to enlarge the narrowed area. Your child’s cardiologist will discuss whether a balloon/stent procedure or surgery is best.

• #27 Truncus Arteriosus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus

  Babies with truncus arteriosus need heart surgery within the first weeks of life. The most common procedure is called a Rastelli repair, which creates two separate paths for blood to leave your babys heart. […] Your babys surgeon will: […] Use a patch to close the hole in your babys heart (VSD) […] Create a new aorta using the existing blood vessel (truncus) […] Create a new aortic valve using the existing truncal valve […] Place an artificial tube (conduit) and artificial valve to create a new pulmonary artery and valve. […] These are the basic steps for repairing truncus arteriosus. Your babys surgery may include other steps if they have other heart defects that need repair. Your babys surgeon will explain exactly whats necessary for their unique heart anatomy. […] Down the road, your child will need more surgeries to keep their heart and blood vessels working normally.

• #28 Truncus Arteriosus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus

  Babies with truncus arteriosus need heart surgery within the first weeks of life. The most common procedure is called a Rastelli repair, which creates two separate paths for blood to leave your babys heart. […] Your babys surgeon will: […] Use a patch to close the hole in your babys heart (VSD) […] Create a new aorta using the existing blood vessel (truncus) […] Create a new aortic valve using the existing truncal valve […] Place an artificial tube (conduit) and artificial valve to create a new pulmonary artery and valve. […] These are the basic steps for repairing truncus arteriosus. Your babys surgery may include other steps if they have other heart defects that need repair. Your babys surgeon will explain exactly whats necessary for their unique heart anatomy. […] Down the road, your child will need more surgeries to keep their heart and blood vessels working normally.

• #29 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Currently, surgical management consists of complete primary repair, with closure of the ventricular septal defect, committing the common arterial trunk to the left ventricle, and reconstruction of the right ventricular outflow tract. […] The ESC class I recommendations for surgical techniques for truncal valve repair are annuloplasty, cusp exclusion, and leaflet plasty; it is best to avoid replacement of the truncal valve. […] Administer routine postoperative care, initially in the cardiac intensive care unit, following correction of truncus arteriosus. Support patients with mechanical ventilation, inotropic medications, and sedation as necessary. […] Postoperative care after repair of truncus arteriosus requires attention to issues that are common to patients with complex congenital heart disease (eg, support of cardiac output) and prevention or management of arrhythmias and end-organ dysfunction.

• #30 Truncus Arteriosus Diagnosis & Treatments | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/truncus-arteriosus

  If your child has associated issues, such as significant narrowing or leaking of the truncal valve, which will become the aortic valve, or if there is aortic arch interruption, we address those issues during the same operation. […] It is important for you to know that your child who has had surgical repair of truncus arteriosus will require lifelong care by a cardiologist. Over time, we will monitor the function of the truncal valve and heart. […] Through it all, we are here for you and your child for life. Our goal is to help your child be a child.

• #31 Persistent Truncus Arteriosus – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/persistent-truncus-arteriosus

  Medical treatment of heart failure (eg, diuretics, digoxin, angiotensin-converting enzyme inhibitors) before surgery […] Surgical repair […] Heart failure is treated vigorously with diuretics, digoxin, and angiotensin-converting enzyme (ACE) inhibitors, followed by early surgical repair. Prostaglandin infusion is beneficial to maintain ductal patency when there is interruption or coarctation of the aortic arch, in which case right-to-left shunt through the ductus provides systemic blood flow. […] Surgical management consists of repair during the neonatal period. The ventricular septal defect is closed so that the left ventricle ejects into the truncal root. […] When a conduit is placed during early infancy, its size becomes inadequate as children grow, and the conduit must be revised during childhood.

• #32 Truncus Arteriosus > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/truncus-arteriosus

  Treatment includes surgery, medication […] Doctors surgically correct truncus arteriosus within the first few months of a babys life. A newborn may need medication (diuretics, digoxin, and ACE inhibitors) to manage the symptoms of heart failure before of surgery. […] When a baby is ready for surgery, often around 1 or 2 months of age, doctors perform several procedures: Doctors use a patch to close the hole in the heart wall (the ventricular septal defect and, in some cases, an atrial septal defect). If the truncal valve is leaky, doctors repair it. Doctors create two blood vesselsa main pulmonary artery and an aortaso blood can travel through the heart on its intended route. […] Doctors usually designate the common trunk as the aorta and the truncal valve as the aortic valve. They route this blood vessel so that oxygen-rich blood from the left ventricle passes through it to the rest of the body. […] Doctors use an artificial blood vessel (a conduit) and an artificial valve to serve as the pulmonary artery and pulmonary valve. They route this new blood vessel so that oxygen-poor blood travels from the right ventricle into the lungs, where the blood becomes oxygenated.

• #33 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Currently, surgical management consists of complete primary repair, with closure of the ventricular septal defect, committing the common arterial trunk to the left ventricle, and reconstruction of the right ventricular outflow tract. […] The ESC class I recommendations for surgical techniques for truncal valve repair are annuloplasty, cusp exclusion, and leaflet plasty; it is best to avoid replacement of the truncal valve. […] Administer routine postoperative care, initially in the cardiac intensive care unit, following correction of truncus arteriosus. Support patients with mechanical ventilation, inotropic medications, and sedation as necessary. […] Postoperative care after repair of truncus arteriosus requires attention to issues that are common to patients with complex congenital heart disease (eg, support of cardiac output) and prevention or management of arrhythmias and end-organ dysfunction.

• #34 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Currently, surgical management consists of complete primary repair, with closure of the ventricular septal defect, committing the common arterial trunk to the left ventricle, and reconstruction of the right ventricular outflow tract. […] The ESC class I recommendations for surgical techniques for truncal valve repair are annuloplasty, cusp exclusion, and leaflet plasty; it is best to avoid replacement of the truncal valve. […] Administer routine postoperative care, initially in the cardiac intensive care unit, following correction of truncus arteriosus. Support patients with mechanical ventilation, inotropic medications, and sedation as necessary. […] Postoperative care after repair of truncus arteriosus requires attention to issues that are common to patients with complex congenital heart disease (eg, support of cardiac output) and prevention or management of arrhythmias and end-organ dysfunction.

• #35 Truncus Arteriosus | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/truncus-arteriosus

  After surgery, your baby will go to the Cardiothoracic Intensive Care Unit (CTICU). They may be on a breathing machine and have many tubes, wires, and equipment to keep them stable and make sure they are okay. Members of their health care team may make changes to your baby’s medicines and breathing machine often. This will happen the most in the first 24 to 48 hours after surgery. […] Other treatments your baby will probably get after surgery are: Antibiotic medicine to prevent infection, Fluids and nutrition through an IV or PICC line, Heart medicines by IV or by mouth, Chest drainage tube, Oxygen, Pain medicines, A tube in the nose to the stomach (nasogastric [NG] tube) to keep the stomach empty, Blood transfusions, when needed.

• #36 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Currently, surgical management consists of complete primary repair, with closure of the ventricular septal defect, committing the common arterial trunk to the left ventricle, and reconstruction of the right ventricular outflow tract. […] The ESC class I recommendations for surgical techniques for truncal valve repair are annuloplasty, cusp exclusion, and leaflet plasty; it is best to avoid replacement of the truncal valve. […] Administer routine postoperative care, initially in the cardiac intensive care unit, following correction of truncus arteriosus. Support patients with mechanical ventilation, inotropic medications, and sedation as necessary. […] Postoperative care after repair of truncus arteriosus requires attention to issues that are common to patients with complex congenital heart disease (eg, support of cardiac output) and prevention or management of arrhythmias and end-organ dysfunction.

• #37 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Currently, surgical management consists of complete primary repair, with closure of the ventricular septal defect, committing the common arterial trunk to the left ventricle, and reconstruction of the right ventricular outflow tract. […] The ESC class I recommendations for surgical techniques for truncal valve repair are annuloplasty, cusp exclusion, and leaflet plasty; it is best to avoid replacement of the truncal valve. […] Administer routine postoperative care, initially in the cardiac intensive care unit, following correction of truncus arteriosus. Support patients with mechanical ventilation, inotropic medications, and sedation as necessary. […] Postoperative care after repair of truncus arteriosus requires attention to issues that are common to patients with complex congenital heart disease (eg, support of cardiac output) and prevention or management of arrhythmias and end-organ dysfunction.

• #38 Truncus Arteriosus Medication: Inotropic agents, Diuretic agents, Cardiac glycoside, antiarrhythmic, ACE inhibitor, afterload reducing agent

  https://emedicine.medscape.com/article/892489-medication

  Pharmacologic therapy in patients with truncus arteriosus depends on various factors, including clinical status, associated lesions, and where in the course of management (eg, preoperative, early postoperative) the patient is when drug therapy is provided. The major classes of cardiac drugs administered to patients with truncus arteriosus include diuretics, digoxin, afterload reducing agents, inotropic medications, and antiarrhythmics if necessary. Consultation with a cardiologist is imperative before beginning, changing, or discontinuing cardiac medications in these patients. […] The European Society of Cardiology indicates vasodilators may provide benefit in the setting of truncus arteriosus and truncal valve regurgitation (class II): […] These agents provide inotropic and chronotropic support in the early postoperative period, when postoperative myocardial edema and ischemia-reperfusion injury may result in varying degrees of residual ventricular dysfunction. Also used at low doses to optimize renal perfusion to facilitate diuresis.

• #39 Truncus Arteriosus | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30641

  The postoperative patient is taken to the CICU for close monitoring and stabilization. Fluid and electrolyte management, sedation and pain control, respiratory control, cardiovascular management, renal function, neurological status, infection control, and nutritional status are all important factors to consider during the postoperative period.

• #40 Truncus Arteriosus | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/truncus-arteriosus

  After surgery, your baby will go to the Cardiothoracic Intensive Care Unit (CTICU). They may be on a breathing machine and have many tubes, wires, and equipment to keep them stable and make sure they are okay. Members of their health care team may make changes to your baby’s medicines and breathing machine often. This will happen the most in the first 24 to 48 hours after surgery. […] Other treatments your baby will probably get after surgery are: Antibiotic medicine to prevent infection, Fluids and nutrition through an IV or PICC line, Heart medicines by IV or by mouth, Chest drainage tube, Oxygen, Pain medicines, A tube in the nose to the stomach (nasogastric [NG] tube) to keep the stomach empty, Blood transfusions, when needed.

• #41 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Management issues include maintenance of intravascular volume and ventricular filling, inotropic support, and acid-base and electrolyte homeostasis. […] The presence of an interrupted arch and severe truncal regurgitation have been linked to elevated risks and poorer outcomes with surgery for common arterial trunk. […] The ESC guidelines indicate the following are recommended as the quoted 30-day postoperative mortality risk associated various subtypes of the common arterial trunk. […] Routine clinical and echocardiographic follow-up care is sufficient to monitor most patients.

• #42 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Management issues include maintenance of intravascular volume and ventricular filling, inotropic support, and acid-base and electrolyte homeostasis. […] The presence of an interrupted arch and severe truncal regurgitation have been linked to elevated risks and poorer outcomes with surgery for common arterial trunk. […] The ESC guidelines indicate the following are recommended as the quoted 30-day postoperative mortality risk associated various subtypes of the common arterial trunk. […] Routine clinical and echocardiographic follow-up care is sufficient to monitor most patients.

• #43 Truncus Arteriosus | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30641

  The postoperative patient is taken to the CICU for close monitoring and stabilization. Fluid and electrolyte management, sedation and pain control, respiratory control, cardiovascular management, renal function, neurological status, infection control, and nutritional status are all important factors to consider during the postoperative period.

• #44 Truncus Arteriosus | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30641

  The postoperative patient is taken to the CICU for close monitoring and stabilization. Fluid and electrolyte management, sedation and pain control, respiratory control, cardiovascular management, renal function, neurological status, infection control, and nutritional status are all important factors to consider during the postoperative period.

• #45 Truncus Arteriosus | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/truncus-arteriosus

  Initial treatment begins with stabilizing the infant. Medications to control congestive heart failure are often started. […] Surgery is typically done in the first few weeks of life after the infant is stabilized. […] The surgical repair of truncus arteriosus uses the heart-lung bypass machine for support. It involves three major parts: Separating the pulmonary arteries from the main truncus, Closing the ventricular septal defect using a patch, Creating a connection between the right ventricle and the pulmonary arteries using a conduit (an artificial tube). […] Infants will need to be watched closely in the Cardiac Intensive Care Unit while they recover. […] Time in the hospital after surgery ranges from one to three weeks in most cases. […] As the child grows, he or she will be followed by a cardiologist. They will need echocardiograms and EKGs.

• #46 Advanced Truncus Arteriosus Treatment in India

  https://www.medicoexperts.com/cardiology/truncus-arteriosus/

  The results are good for most children after truncus arteriosus surgery. The success rate of this surgery is more than 90%. […] After surgery, typically stay in the hospital will be one week, in case of uncomplicated recovery. In the first weeks of life of your child, the hospital stay likely will be longer. Most children go on to live healthy, productive lives after repair. […] Ideally, for optimal results and better outcomes, it is appropriate to choose to go for surgery before your baby is two months old. […] During the truncus arteriosus surgery, the surgeon will put a conduit. As the child grows, the conduit used to construct the pulmonary artery will need to be changed, therefore requiring a second surgery. […] Untreated truncus could lead to complications and death, usually in the first year of life.

• #47 Truncus arteriosus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/truncus-arteriosus/diagnosis-treatment/drc-20364277

  Infants with truncus arteriosus need surgery to improve blood flow and oxygen levels. Many procedures or surgeries might be needed, especially as a child grows. Medicines might be given before surgery to help improve heart health. […] Children and adults with surgically repaired truncus arteriosus need regular health checkups for life. […] Most infants with truncus arteriosus have surgery within the first few weeks after birth. The specific type of surgery depends on the baby’s condition. Usually, the baby’s surgeon: […] After surgery for truncus arteriosus, a person needs lifelong follow-up care with a heart doctor specializing in congenital disease. This type of healthcare professional is called a congenital cardiologist.

• #48 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Children with truncus arteriosus need regular follow-up with a pediatric cardiologist and they may need to take medicine after surgery. Your child’s cardiologist will evaluate with a variety of tests including electrocardiograms and echocardiograms to determine when another procedure such as cardiac catheterization may be needed. […] Patients with truncus arteriosus need regular follow-up with a cardiologist with special training in adult congenital heart disease. You may need to take medicine after your operation to help your heart pump better. […] The conduit and valve will need to be replaced at least two or three times in childhood and may also need to be replaced in adulthood. There are new catheter-based procedures that may allow the pulmonary valve to be replaced without surgery. In a smaller number of patients the truncal valve may also need to be repaired or replaced surgically.

• #49 Truncus Arteriosus | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/truncus-arteriosus

  Typically, there are no physical restrictions on the child. […] The child will eventually need an open-heart surgery to replace the right ventricle to pulmonary artery conduit with a larger one. […] These surgeries are tolerated very well with a hospitalization of less than a week. […] Problems with the truncal valve are more serious. They can significantly affect the early and late outcomes of these children. The leakier or more narrowed this valve is, the greater the chance that some intervention will need to be done (on average within five to seven years) to prevent severe damage to the heart.

• #50 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Children with truncus arteriosus need regular follow-up with a pediatric cardiologist and they may need to take medicine after surgery. Your child’s cardiologist will evaluate with a variety of tests including electrocardiograms and echocardiograms to determine when another procedure such as cardiac catheterization may be needed. […] Patients with truncus arteriosus need regular follow-up with a cardiologist with special training in adult congenital heart disease. You may need to take medicine after your operation to help your heart pump better. […] The conduit and valve will need to be replaced at least two or three times in childhood and may also need to be replaced in adulthood. There are new catheter-based procedures that may allow the pulmonary valve to be replaced without surgery. In a smaller number of patients the truncal valve may also need to be repaired or replaced surgically.

• #51 Truncus Arteriosus Repair

  https://www.rwjbh.org/treatment-care/heart-and-vascular-care/tests-procedures/truncus-arteriosus-repair/

  To address TA, open-heart surgery (involves dividing the breast bone / general anesthesia) will be performed within the first 2 weeks of your babys life. […] The operation uses a conduit which is a tube made of either Dacron with a pig valve inside it or a donated human valve and artery (called a homograft valve). One end of the conduit/homograft is sewn into the right ventricle and the other end is sewn into the pulmonary artery. […] Most children with truncus arteriosus will need their conduit/homograft replaced two to three times before they reach adulthood.

• #52 Truncus Arteriosus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus

  Your childs surgeon will tell you more about future surgeries and what theyll involve. Your child will likely need another surgery within three to 10 years after their first one, and possibly more after that. […] Follow the appointment schedule your childs care team provides. Your child will need routine appointments with a heart specialist (pediatric cardiologist). […] This ongoing care is very important. Your childs providers will: […] Run tests, including imaging tests and cardiac catheterizations, to see how your childs heart is functioning […] Perform additional surgeries, as needed, to address issues with the conduit or valves. […] Yes, but they need surgical repair to survive. The survival rate for truncus arteriosus surgery is 80% to 97%, according to the latest research. […] About 75% of babies who have surgical repair are alive 20 years later. […] Your childs care team can tell you more about the factors that might affect your childs life expectancy.

• #53 Truncus Arteriosus | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/truncus-arteriosus

  Typically, there are no physical restrictions on the child. […] The child will eventually need an open-heart surgery to replace the right ventricle to pulmonary artery conduit with a larger one. […] These surgeries are tolerated very well with a hospitalization of less than a week. […] Problems with the truncal valve are more serious. They can significantly affect the early and late outcomes of these children. The leakier or more narrowed this valve is, the greater the chance that some intervention will need to be done (on average within five to seven years) to prevent severe damage to the heart.

• #54 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Sometimes conduits and peripheral pulmonary artery obstructions may be dilated using a balloon-tipped catheter or an expandable stent in the cardiac catheterization laboratory. This procedure may help extend the time between conduit changes. Sometimes surgery is required to enlarge the narrowed area. Your cardiologist will decide whether a balloon/stent procedure or surgery is best for you.

• #55 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Sometimes conduits and peripheral pulmonary artery obstructions may be dilated using a balloon-tipped catheter or an expandable stent in the cardiac catheterization laboratory. This procedure may help extend the time between conduit changes. Sometimes surgery is required to enlarge the narrowed area. Your cardiologist will decide whether a balloon/stent procedure or surgery is best for you.

• #56 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Sometimes conduits and peripheral pulmonary artery obstructions may be dilated using a balloon-tipped catheter or an expandable stent in the cardiac catheterization laboratory. This procedure may help extend the time between conduit changes. Sometimes surgery is required to enlarge the narrowed area. Your cardiologist will decide whether a balloon/stent procedure or surgery is best for you.

• #57 Persistent truncus arteriosus – treatment in Israel

  https://www.resultmed.com/cardiology/pta/

  Recently, our surgeons are increasingly use procedures such as balloon angioplasty. This procedure is performed by inserting a catheter into a vein in a child that does not require opening the chest. Cardiac catheterization with an inflatable stent allows to reveal and expand difficult or narrowed arteries, which can delay the need for further surgery. […] Women who were operated on in infancy on the truncus arteriosus, before planning pregnancy should be examined by a cardiologist and expert on birth defects in adults, and the obstetrician who specializes in high-risk pregnancies. Depending on the level of lung injury that occurred prior to surgery, pregnancy may or may not be recommended. In addition, some medications taken for the heart, can be harmful to the fetus.

• #58 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Children with truncus arteriosus need regular follow-up with a pediatric cardiologist and they may need to take medicine after surgery. Your child’s cardiologist will evaluate with a variety of tests including electrocardiograms and echocardiograms to determine when another procedure such as cardiac catheterization may be needed. […] Patients with truncus arteriosus need regular follow-up with a cardiologist with special training in adult congenital heart disease. You may need to take medicine after your operation to help your heart pump better. […] The conduit and valve will need to be replaced at least two or three times in childhood and may also need to be replaced in adulthood. There are new catheter-based procedures that may allow the pulmonary valve to be replaced without surgery. In a smaller number of patients the truncal valve may also need to be repaired or replaced surgically.

• #59 Truncus Arteriosus | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/truncus-arteriosus

  Typically, there are no physical restrictions on the child. […] The child will eventually need an open-heart surgery to replace the right ventricle to pulmonary artery conduit with a larger one. […] These surgeries are tolerated very well with a hospitalization of less than a week. […] Problems with the truncal valve are more serious. They can significantly affect the early and late outcomes of these children. The leakier or more narrowed this valve is, the greater the chance that some intervention will need to be done (on average within five to seven years) to prevent severe damage to the heart.

• #60 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  Management strategies aim at minimizing the frequency and invasiveness of reintervention, thereby optimizing functional performance and overall quality of life and improving long-term survival. […] As adequate truncal valve intervention improves survival, timely and advanced tailored techniques are required for truncal valve repair before left ventricular dysfunction occurs. […] It is very important for the initial repair to be as durable as possible, and optimizing truncal valve function can reduce the number of repeated interventions. […] Currently, the best surgical results can be achieved despite long CPB durations, because more adequate repairs with improved perfusion strategies and meticulous perioperative care have all reduced the impact of prolonged CPB on worse outcomes. […] It is very important to perform the initial repair using the most durable type and size of conduit.

• #61 Truncus Arteriosus

  https://scts.org/patients/congenital/procedures/36/truncus_arteriosus/

  Untreated, truncus arteriosus can be fatal. Surgery to repair truncus arteriosus is generally successful, especially if the repair occurs before your baby is 1 month old. […] Infants with truncus arteriosus must have surgery. Multiple procedures or surgeries might be necessary, especially as your child grows. Medications might be given before surgery to help improve heart health. […] Medications that might be prescribed before surgery include: Diuretics. Often called water pills, diuretics increase the frequency and volume of urination, preventing fluid from collecting in the body, which is a common effect of heart failure. Inotropic agents. This type of medication strengthens the heart’s contractions. […] Most infants with truncus arteriosus have surgery within the first few weeks after birth. The procedure will depend on your baby’s condition. Most commonly your baby’s surgeon will: Close the hole between the two ventricles with a patch, Separate the upper portion of the pulmonary artery from the single large vessel, Implant a tube and valve to connect the right ventricle with the upper portion of the pulmonary artery creating a new, complete pulmonary artery, Reconstruct the single large vessel and aorta to create a new, complete aorta.

• #62 Truncus Arteriosus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus

  Your childs surgeon will tell you more about future surgeries and what theyll involve. Your child will likely need another surgery within three to 10 years after their first one, and possibly more after that. […] Follow the appointment schedule your childs care team provides. Your child will need routine appointments with a heart specialist (pediatric cardiologist). […] This ongoing care is very important. Your childs providers will: […] Run tests, including imaging tests and cardiac catheterizations, to see how your childs heart is functioning […] Perform additional surgeries, as needed, to address issues with the conduit or valves. […] Yes, but they need surgical repair to survive. The survival rate for truncus arteriosus surgery is 80% to 97%, according to the latest research. […] About 75% of babies who have surgical repair are alive 20 years later. […] Your childs care team can tell you more about the factors that might affect your childs life expectancy.

• #63 Truncus Arteriosus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus

  Your childs surgeon will tell you more about future surgeries and what theyll involve. Your child will likely need another surgery within three to 10 years after their first one, and possibly more after that. […] Follow the appointment schedule your childs care team provides. Your child will need routine appointments with a heart specialist (pediatric cardiologist). […] This ongoing care is very important. Your childs providers will: […] Run tests, including imaging tests and cardiac catheterizations, to see how your childs heart is functioning […] Perform additional surgeries, as needed, to address issues with the conduit or valves. […] Yes, but they need surgical repair to survive. The survival rate for truncus arteriosus surgery is 80% to 97%, according to the latest research. […] About 75% of babies who have surgical repair are alive 20 years later. […] Your childs care team can tell you more about the factors that might affect your childs life expectancy.

• #64 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  Recent improvements in cardiopulmonary bypass (CPB), surgical techniques, prenatal diagnosis, and perioperative management have reduced mortality for truncus arteriosus, which has an early mortality rate of 3% to 20% and long-term survival of approximately 75% at 20 years. […] In the current era, early single-staged surgical correction of the truncal defect and its associated pathologies is recommended. […] As survival for patients with truncus arteriosus continues to improve, the importance of tailored management, such as adequate repair with meticulous surgery and vigilant perioperative monitoring, cannot be overemphasized for successful outcomes, particularly in high-risk patients such as those with prematurity, genetic anomalies, extracardiac problems, very low weight, preoperative shock, truncal valve dysfunction, and arch anomaly.

• #65 Truncus Arteriosus Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/892489-treatment

  Management issues include maintenance of intravascular volume and ventricular filling, inotropic support, and acid-base and electrolyte homeostasis. […] The presence of an interrupted arch and severe truncal regurgitation have been linked to elevated risks and poorer outcomes with surgery for common arterial trunk. […] The ESC guidelines indicate the following are recommended as the quoted 30-day postoperative mortality risk associated various subtypes of the common arterial trunk. […] Routine clinical and echocardiographic follow-up care is sufficient to monitor most patients.

• #66 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  Recent improvements in cardiopulmonary bypass (CPB), surgical techniques, prenatal diagnosis, and perioperative management have reduced mortality for truncus arteriosus, which has an early mortality rate of 3% to 20% and long-term survival of approximately 75% at 20 years. […] In the current era, early single-staged surgical correction of the truncal defect and its associated pathologies is recommended. […] As survival for patients with truncus arteriosus continues to improve, the importance of tailored management, such as adequate repair with meticulous surgery and vigilant perioperative monitoring, cannot be overemphasized for successful outcomes, particularly in high-risk patients such as those with prematurity, genetic anomalies, extracardiac problems, very low weight, preoperative shock, truncal valve dysfunction, and arch anomaly.

• #67 Truncus Arteriosus | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/t/truncus-arteriosus

  Initial treatment begins with stabilizing the infant. Medications to control congestive heart failure are often started. […] Surgery is typically done in the first few weeks of life after the infant is stabilized. […] The surgical repair of truncus arteriosus uses the heart-lung bypass machine for support. It involves three major parts: Separating the pulmonary arteries from the main truncus, Closing the ventricular septal defect using a patch, Creating a connection between the right ventricle and the pulmonary arteries using a conduit (an artificial tube). […] Infants will need to be watched closely in the Cardiac Intensive Care Unit while they recover. […] Time in the hospital after surgery ranges from one to three weeks in most cases. […] As the child grows, he or she will be followed by a cardiologist. They will need echocardiograms and EKGs.

• #68 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Children with truncus arteriosus need regular follow-up with a pediatric cardiologist and they may need to take medicine after surgery. Your child’s cardiologist will evaluate with a variety of tests including electrocardiograms and echocardiograms to determine when another procedure such as cardiac catheterization may be needed. […] Patients with truncus arteriosus need regular follow-up with a cardiologist with special training in adult congenital heart disease. You may need to take medicine after your operation to help your heart pump better. […] The conduit and valve will need to be replaced at least two or three times in childhood and may also need to be replaced in adulthood. There are new catheter-based procedures that may allow the pulmonary valve to be replaced without surgery. In a smaller number of patients the truncal valve may also need to be repaired or replaced surgically.

• #69 Truncus Arteriosus: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/14785-truncus-arteriosus

  Your childs surgeon will tell you more about future surgeries and what theyll involve. Your child will likely need another surgery within three to 10 years after their first one, and possibly more after that. […] Follow the appointment schedule your childs care team provides. Your child will need routine appointments with a heart specialist (pediatric cardiologist). […] This ongoing care is very important. Your childs providers will: […] Run tests, including imaging tests and cardiac catheterizations, to see how your childs heart is functioning […] Perform additional surgeries, as needed, to address issues with the conduit or valves. […] Yes, but they need surgical repair to survive. The survival rate for truncus arteriosus surgery is 80% to 97%, according to the latest research. […] About 75% of babies who have surgical repair are alive 20 years later. […] Your childs care team can tell you more about the factors that might affect your childs life expectancy.

• #70 Truncus Arteriosus

  https://scts.org/patients/congenital/procedures/36/truncus_arteriosus/

  After corrective surgery, your child will need lifelong follow-up care with a cardiologist. The cardiologist might recommend that your child limit physical activity, particularly intense competitive sports. Your child will need to take antibiotics before dental procedures and other surgical procedures to prevent infections. Because the artificial conduit does not grow with your child, follow-up surgeries to replace the conduit valve are necessary as he or she ages. […] Minimally invasive procedures use a cardiac catheter to avoid the need for traditional heart surgery as your child grows or previously placed artificial valves deteriorate. The catheter is inserted into a blood vessel in the leg that is then threaded up to the heart to replace the conduit. In addition, cardiac catheterization with an inflatable balloon tip can be used to open up an obstructed or narrowed artery, which might delay the need for follow-up surgery. […] Women who’ve had surgery to repair truncus arteriosus in infancy need to be evaluated by a cardiologist with expertise in adult congenital heart defects and an obstetrician specializing in high-risk pregnancies before attempting to become pregnant.

• #71 Truncus Arteriosus

  https://scts.org/patients/congenital/procedures/36/truncus_arteriosus/

  After corrective surgery, your child will need lifelong follow-up care with a cardiologist. The cardiologist might recommend that your child limit physical activity, particularly intense competitive sports. Your child will need to take antibiotics before dental procedures and other surgical procedures to prevent infections. Because the artificial conduit does not grow with your child, follow-up surgeries to replace the conduit valve are necessary as he or she ages. […] Minimally invasive procedures use a cardiac catheter to avoid the need for traditional heart surgery as your child grows or previously placed artificial valves deteriorate. The catheter is inserted into a blood vessel in the leg that is then threaded up to the heart to replace the conduit. In addition, cardiac catheterization with an inflatable balloon tip can be used to open up an obstructed or narrowed artery, which might delay the need for follow-up surgery. […] Women who’ve had surgery to repair truncus arteriosus in infancy need to be evaluated by a cardiologist with expertise in adult congenital heart defects and an obstetrician specializing in high-risk pregnancies before attempting to become pregnant.

• #72 Persistent Truncus Arteriosus – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/birth-defects-of-the-heart/persistent-truncus-arteriosus

  Medical treatment for heart failure is typically followed by early surgical repair. […] Heart failure is treated with medications to improve breathing and stabilize the infant until surgery can be done. […] Surgery is usually done before the infant is 1 to 2 months old. The ventricular septal defect is repaired with a patch that directs all blood flow from the left ventricle to the truncal valve. Then doctors separate the pulmonary arteries from the truncus and attach them to the right ventricle using a tube (conduit). After this repair, the truncus functions as the aorta. […] When a conduit is placed during early infancy, its size becomes inadequate as children grow, and additional surgery is needed to enlarge the conduit. […] After surgical repair, affected children need to take antibiotics before visits to the dentist and before certain surgeries (such as on the respiratory tract). These antibiotics are used to prevent a serious heart infection called endocarditis.

• #73 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Children with truncus arteriosus need regular follow-up with a pediatric cardiologist and they may need to take medicine after surgery. Your child’s cardiologist will evaluate with a variety of tests including electrocardiograms and echocardiograms to determine when another procedure such as cardiac catheterization may be needed. […] Patients with truncus arteriosus need regular follow-up with a cardiologist with special training in adult congenital heart disease. You may need to take medicine after your operation to help your heart pump better. […] The conduit and valve will need to be replaced at least two or three times in childhood and may also need to be replaced in adulthood. There are new catheter-based procedures that may allow the pulmonary valve to be replaced without surgery. In a smaller number of patients the truncal valve may also need to be repaired or replaced surgically.

• #74 Truncus Arteriosus | American Heart Association

  https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/truncus-arteriosus

  Children with truncus arteriosus need regular follow-up with a pediatric cardiologist and they may need to take medicine after surgery. Your child’s cardiologist will evaluate with a variety of tests including electrocardiograms and echocardiograms to determine when another procedure such as cardiac catheterization may be needed. […] Patients with truncus arteriosus need regular follow-up with a cardiologist with special training in adult congenital heart disease. You may need to take medicine after your operation to help your heart pump better. […] The conduit and valve will need to be replaced at least two or three times in childhood and may also need to be replaced in adulthood. There are new catheter-based procedures that may allow the pulmonary valve to be replaced without surgery. In a smaller number of patients the truncal valve may also need to be repaired or replaced surgically.

• #75 Truncus Arteriosus

  https://scts.org/patients/congenital/procedures/36/truncus_arteriosus/

  After corrective surgery, your child will need lifelong follow-up care with a cardiologist. The cardiologist might recommend that your child limit physical activity, particularly intense competitive sports. Your child will need to take antibiotics before dental procedures and other surgical procedures to prevent infections. Because the artificial conduit does not grow with your child, follow-up surgeries to replace the conduit valve are necessary as he or she ages. […] Minimally invasive procedures use a cardiac catheter to avoid the need for traditional heart surgery as your child grows or previously placed artificial valves deteriorate. The catheter is inserted into a blood vessel in the leg that is then threaded up to the heart to replace the conduit. In addition, cardiac catheterization with an inflatable balloon tip can be used to open up an obstructed or narrowed artery, which might delay the need for follow-up surgery. […] Women who’ve had surgery to repair truncus arteriosus in infancy need to be evaluated by a cardiologist with expertise in adult congenital heart defects and an obstetrician specializing in high-risk pregnancies before attempting to become pregnant.

• #76 Persistent truncus arteriosus – treatment in Israel

  https://www.resultmed.com/cardiology/pta/

  Recently, our surgeons are increasingly use procedures such as balloon angioplasty. This procedure is performed by inserting a catheter into a vein in a child that does not require opening the chest. Cardiac catheterization with an inflatable stent allows to reveal and expand difficult or narrowed arteries, which can delay the need for further surgery. […] Women who were operated on in infancy on the truncus arteriosus, before planning pregnancy should be examined by a cardiologist and expert on birth defects in adults, and the obstetrician who specializes in high-risk pregnancies. Depending on the level of lung injury that occurred prior to surgery, pregnancy may or may not be recommended. In addition, some medications taken for the heart, can be harmful to the fetus.

• #77 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  A tailored approach with an optimal conduit type and size is critical, particularly in patients with complex anatomy. […] Future studies need to be improved by data segmentation and important details to identify factors associated with better long-term outcomes, and a systematically developed, prospective multi-institutional database is necessary to establish optimally tailored treatment strategies.

• #78 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  Management strategies aim at minimizing the frequency and invasiveness of reintervention, thereby optimizing functional performance and overall quality of life and improving long-term survival. […] As adequate truncal valve intervention improves survival, timely and advanced tailored techniques are required for truncal valve repair before left ventricular dysfunction occurs. […] It is very important for the initial repair to be as durable as possible, and optimizing truncal valve function can reduce the number of repeated interventions. […] Currently, the best surgical results can be achieved despite long CPB durations, because more adequate repairs with improved perfusion strategies and meticulous perioperative care have all reduced the impact of prolonged CPB on worse outcomes. […] It is very important to perform the initial repair using the most durable type and size of conduit.

• #79 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  Management strategies aim at minimizing the frequency and invasiveness of reintervention, thereby optimizing functional performance and overall quality of life and improving long-term survival. […] As adequate truncal valve intervention improves survival, timely and advanced tailored techniques are required for truncal valve repair before left ventricular dysfunction occurs. […] It is very important for the initial repair to be as durable as possible, and optimizing truncal valve function can reduce the number of repeated interventions. […] Currently, the best surgical results can be achieved despite long CPB durations, because more adequate repairs with improved perfusion strategies and meticulous perioperative care have all reduced the impact of prolonged CPB on worse outcomes. […] It is very important to perform the initial repair using the most durable type and size of conduit.

• #80 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  Management strategies aim at minimizing the frequency and invasiveness of reintervention, thereby optimizing functional performance and overall quality of life and improving long-term survival. […] As adequate truncal valve intervention improves survival, timely and advanced tailored techniques are required for truncal valve repair before left ventricular dysfunction occurs. […] It is very important for the initial repair to be as durable as possible, and optimizing truncal valve function can reduce the number of repeated interventions. […] Currently, the best surgical results can be achieved despite long CPB durations, because more adequate repairs with improved perfusion strategies and meticulous perioperative care have all reduced the impact of prolonged CPB on worse outcomes. […] It is very important to perform the initial repair using the most durable type and size of conduit.

• #81 Truncus Arteriosus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534774/

  Primary palliation with pulmonary arterial banding and delayed surgical repair may be required to allow the infant to grow. […] The postoperative patient is taken to the CICU for close monitoring and stabilization. […] An interprofessional approach to patients with truncus arteriosus is recommended to improve outcomes.

• #82 Pediatric Truncus Arteriosus | Memorial Hermann

  https://memorialhermann.org/services/conditions/pediatric-truncus-arteriosus

  Innovations at Children’s Memorial Hermann Hospital in the treatment of truncus arteriosus include: Surgical strategies for patients with the highest risk subtypes, All-natural tissue repairs, Re-operative valve repair for older patients with truncus arteriosus, Advanced perfusion strategies, “Hybrid” collaborations between interventional cardiology and cardiac surgery.

• #83 Commentary: Treatment for Truncus Arteriosus Needs to Be Tailored

  https://www.jchestsurg.org/journal/view.html?doi=10.5090/jcs.23.018

  A tailored approach with an optimal conduit type and size is critical, particularly in patients with complex anatomy. […] Future studies need to be improved by data segmentation and important details to identify factors associated with better long-term outcomes, and a systematically developed, prospective multi-institutional database is necessary to establish optimally tailored treatment strategies.

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