PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Truncus Arteriosus, Persistent”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1988

Common arterial trunk with pulmonary atresia.

We describe a congenitally malformed heart with usual atrial arrangement and concordant atrioventricular connexions in which a solitary arterial trunk left the base of the heart and supplied the coronary and systemic arteries. Pulmonary blood supply was derived from systemic to pulmonary collateral arteries but, in addition, hypoplastic intrapericardial pulmonary arteries were found in each lung hilum. The two sets of hilar arteries were discontinuous, but it seemed likely that this discontinuity had been artefactually produced by prior dissection. Irrespective of this matter, the left pulmonary arteries were connected by a thread-like atretic cord to the left-sided sinus of the solitary arterial trunk. This indicates that, initially, there had been a common trunk which now demonstrates pulmonary atresia. The significance of this lesion is discussed in the light of the nomenclature and description of hearts with common arterial trunk.

Heart Defects, Congenital↗
PubMed1991

Morphogenetic considerations on congenital malformations of the outflow tract. Part 1: Common arterial trunk and tetralogy of Fallot.

On the basis of our recent embryologic work concerning the separation process of the outflow tract, together with our study of the morphology of specimens from the Leiden Collection of malformed hearts, we have reconsidered, in conjunction with the pertinent literature, the morphogenesis of common arterial trunk and tetralogy of Fallot. The constant characteristics of common arterial trunk, namely a common trunk, a common arterial orifice and a ventricular septal defect, can be explained simply by absence of the aorto-pulmonary septum, or its complete failure to contribute to the process of separation. The nature of the variable morphologic features, however, is not always clear. Presence of such variation is not contradictory to the explanation of the main characteristics in this malformation. Tetralogy of Fallot, in contrast, can be considered to result from anterior displacement of the columns of the aorto-pulmonary septum relative to the outlet segment and its proximal boundary, the primary fold. Our findings, and suggestions, diverge considerably from conventional theories concerning the morphogenesis of these malformations.

Heart Septal Defects, Ventricular↗
PubMed1991

Tricuspid atresia with common arterial trunk: surgical palliation in a neonate.

A two-week-old asymptomatic baby was diagnosed by cross-sectional and Doppler ultrasound to have tricuspid atresia with a common arterial trunk. Successful surgical palliation was undertaken at 17 days of age, by disconnection of the pulmonary arteries from the trunk, and creation of an aortopulmonary shunt. There are no known previous reports of surgical palliation of this lesion.

Echocardiography↗
PubMed1987

Truncus arteriosus type A3: complex repair with cryopreserved pulmonary homograft.

A 6-year-old girl with truncus arteriosus type A3, one of the rarest anatomic types, underwent corrective surgery using a cryopreserved valved pulmonary homograft. The special anatomic features in this case were individual origin of the pulmonary arteries. The right pulmonary artery came directly off the truncal vessel, whereas the left pulmonary artery was connected to the aortic arch via a stenotic ductus or ductus-like vessel. The preoperative pulmonary blood flow distribution was 94% on the right versus 6% on the left side. The underperfusion of the left lung may have been related to pulmonary hypoplasia due to long lasting stenosis at the left pulmonary artery take off. The postoperative pulmonary blood flow distribution was 67% on the right versus 33% on the left side. The operative and postoperative course has been uneventful; presently, 6 months after the operation, the patient is in improved clinical condition.

Angiocardiography↗
PubMed1993

Salvage of postoperative pulmonary hypertensive crisis using ECMO via cervical cannulation in a case of truncus arteriosus.

The survival of patients with truncus arteriosus beyond one year of age is rare without surgical treatment [3 . Early surgery may be associated with a mortality but is still preferable, as the risks of established pulmonary hypertensive disease complicate delayed surgery [2]. We report the successful salvage of a pulmonary hypertensive crisis 24 h after corrective surgery in a late presenting patient using extracorporeal membrane oxygenation (ECMO) via cervical cannulation. Post-operative pulmonary hypertensive crises may present a difficult management problem. Extracorporeal membrane oxygenation is therapeutic in these circumstances in addition to providing life support. Cervical cannulation remains the method of choice in the postoperative cardiac patient.

Catheterization↗
PubMed2004

Chest pain in an adult with truncus arteriosus communis.

We present a case of an adult patient with truncus arteriosus communis and secondary pulmonary hypertension. He had chest pain and sudden death due to cardiac tamponade caused by intramural-limited dissection and rupture of the common trunk.

Adult↗
PubMed2004

Associated factors and trends in outcomes of interrupted aortic arch.

BACKGROUND: Interrupted aortic arch (IAA) continues to be associated with important mortality, both before and immediately after repair, with ongoing morbidity during follow-up. We sought to determine trends in presentation, management, outcomes and associated factors. METHODS: We reviewed all consecutive patients (n = 119) presenting from 1975 to 1999, and data were collected regarding demographics, anatomy, management and outcomes. RESULTS: Significant trends over time for patients born in three consecutive periods (1975 to 1984, 1985 to 1993, and 1994 to 1999) demonstrated a smaller proportion of patients with presentation with circulatory collapse (65%, 51%, and 25%, respectively), greater use of prostaglandins (72%, 90%, 100%), fewer deaths without IAA repair (49%, 15%, 13%) and greater use of one-stage repair (68%, 75%, 100%). Independent risk factors for death without IAA repair (p < 0.001) included absence of ventricular septal defect, and the presence of noncardiac anomaly, complex cardiac anomaly, episode of acidosis and earlier birth cohort. Overall survival after repair was 50% at age 1 month, 35% at 1 year, and 34% at 5 years. Early and constant-hazard phases were noted, with incremental risk factors for early phase mortality being cyanosis at presentation, presence of truncus arteriosus or aortic stenosis, an episode of circulatory collapse before repair, earlier date of repair, and lower weight at repair. Greatest survival occurred in those patients with uncomplicated IAA who had repair since 1993 (5 year survival, 83%). Freedom from reintervention for arch obstruction was 60% at 5 years. CONCLUSIONS: While improving, outcomes of IAA remain of concern, especially in patients with associated lesions.

Abnormalities, Multiple↗
PubMed2005

Repair of truncus arteriosus and aortic arch interruption: outcome analysis.

BACKGROUND: The excellent results for repair of truncus arteriosus reported in some centers have not applied to patients with associated interrupted aortic arch. This work aims at understanding the discrepancy of results in our own experience. PATIENTS AND METHODS: Ten patients among 83 consecutive children with truncus arteriosus repaired from 1987 to September 2004 who had aortic arch interruption were analyzed, with particular emphasis on clinical presentation and outcome. The comprehensive Aristotle complexity score was calculated for each patient. The Kaplan-Meier method was used to estimate survivals. RESULTS: Preoperative mechanical ventilation was necessary in 5 of the 10 patients; 2 of them were moribund. Associated major lesions were as follows: severe (n = 2) and moderate (n = 4) truncal valve regurgitation, coronary artery anomalies (n = 3) and Di-George's syndrome (n = 4). The comprehensive Aristotle score was at least 20 in 6 patients. There were 5 operative deaths (5 of 10); early mortality was 50% (95% confidence limits: 19% to 81%). These deaths occurred in patients with Aristotle score of 20 or greater (5 of 6 = 83%). All 4 patients who had no moderate or severe truncal valve regurgitation survived the intervention. Survival was a low 37.5% +/- 16.1% from 1 year on compared with a high 95.5% +/- 2.5% for the 73 patients without aortic arch interruption. CONCLUSIONS: This study confirms the predictive value of the Aristotle score, hospital mortality being significantly correlated with the highest Aristotle score (p = 0.024). To improve outcome in these high-risk patients, preoperative management should be optimized, repair should not be delayed, and regurgitant truncal valve should be repaired or replaced.

Aorta, Thoracic↗
PubMed2006

Truncus arteriosus associated with interrupted aortic arch in 50 neonates: a Congenital Heart Surgeons Society study.

BACKGROUND: Patients with both interrupted aortic arch (IAA) and truncus arteriosus (TA) have worse outcomes than those with either lesion in isolation. We determined outcomes and associated factors in this rare group. METHODS: From 1987 to 1997, 50 (11%) of 472 neonates with IAA were identified with TA. Site of aortic arch interruption was distal to the left subclavian artery in 16% and between the left common carotid and subclavian artery in 84%. From the common arterial trunk, the pulmonary arteries arose from a main pulmonary trunk in 46%, common orifice in 22%, and separate orifices in 32%. At presentation, truncal valve stenosis was present in 12% and regurgitation in 22%. RESULTS: There were 34 deaths, with a single early hazard phase. Overall survival from admission was 44%, 39%, and 31% at 6 months, 1 year, and 10 years, respectively. One patient had primary cardiac transplantation and 4 died without any intervention. The IAA repair alone was performed in 7 patients, with single stage repair of both IAA and TA in 38 patients. Associated factors for overall time-related death include female gender (p < 0.001), type III TA (p < 0.001) and one institution (low-risk; p < 0.001). Results improved somewhat over time (p < 0.001). At 5 years after IAA repair only 28% were alive without arch repair intervention, and at 5 years after TA repair only 18% were alive without conduit reoperation. CONCLUSIONS: The combination of IAA and TA carries high early mortality, with high risk of reinterventions in survivors. One stage repair of both TA and IAA is the optimal management.

Abnormalities, Multiple↗
PubMed2006

Invited commentary.

Explore the source record for details and available documents.

Abnormalities, Multiple↗
PubMed2006

Rapid diagnosis of cannula migration by cerebral oximetry in neonatal arch repair.

Although it has gained much interest in other surgical specialties, the application of near-infrared spectroscopy to assess cerebral perfusion during cardiac surgery is relatively new. Regional cerebral oxygen saturation (rSO2) is a function of cerebral oxygen supply and demand. Continuous monitoring of the rSO2 permits early detection of cerebral ischemia allowing for prompt intervention. The following is a description of a repair of truncus arteriosus with type A interrupted aortic arch during which continuous cerebral oximetry assisted with the positioning of the arterial cannula avoiding a prolonged episode of cerebral ischemia.

Aorta, Thoracic↗
PubMed2006

Transplantation in truncus arteriosus combined with interrupted aortic arch.

We present the case of an infant with truncus arteriosus combined with a dysplastic truncal valve not amenable to repair and interrupted aortic arch. Due to the disappointing results of truncal valve replacement we decided to perform cardiac transplantation. The infant survived transplantation and was discharged 4 weeks after surgery.

Aorta, Thoracic↗