| From your Guide Dr.MANI |  | |
Truncus Arteriosus | ||
| From your Guide Dr.MANI | | |
Truncus Arteriosus | ||
| |
What happens if truncus arteriosus is not treated ?
The natural history (without treatment) of this condition is very bad. Nearly one half of patients succumb to the disease within one month of life. Only one in ten survive to their first birthday. Even among these few survivors, long term outcome is not promising. Many develop pulmonary vascular obstructive disease and fall a victim to pulmonary hypertension or rarely infective endocarditis.
Should truncus arteriosus be operated ?
The poor natural history of this condition makes surgery mandatory in almost all cases as soon as the diagnosis is made. Operation is preferred at the earliest date to minimise the risks caused by high lung blood flow for a prolonged period.
What are the treatment options for truncus ?
Being such a complex condition with serious consequences even at a young age, the only treatment currently available today is early operation. Many centers are now able to operate on these patients even within the first month of life with good results.
What is the operative repair for truncus arteriosus ?
What is a valved conduit ?
In its simplest form, the repair involves
This requires an open heart operation, and sometimes involves the use of a technique called "Total Circulatory Arrest".
The patient is hooked up to the heart lung machine and the heart beat stopped. The first step in the operation is to disconnect the pulmonary artery (or its branches) from the common arterial trunk. The hole left in the truncus is closed, either directly by sutures, or if it is large, by using a patch made of fabric (Dacron, PTFE).
The right ventricle is then opened and the VSD visualised. The VSD is commonly located right below the truncal valve, and it is repaired in the usual manner with a patch of fabric held in place with sutures of polypropylene.
The connection between the right ventricle and pulmonary artery is then established using a valved conduit.
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