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Common arterial trunk in functionally univentricular hearts: a case series

Published online by Cambridge University Press:  11 July 2022

Huzeifa Elhedai Open the ORCID record for Huzeifa Elhedai [Opens in a new window] ,
Sanfui Yong ,
Milind Chaudhari ,
Phil Botha ,
Paul Miller  and
Oliver Stumper
Huzeifa Elhedai*
Affiliation:
Department of Cardiology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
Sanfui Yong
Affiliation:
Department of Cardiology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
Milind Chaudhari
Affiliation:
Department of Cardiology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
Phil Botha
Affiliation:
Department of Cardiac Surgery, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
Paul Miller
Affiliation:
Department of Cardiology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
Oliver Stumper
Affiliation:
Department of Cardiology, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
*
Author for correspondence: Dr. Huzeifa Elhedai, Birmingham Children’s Hospital NHS Foundation Trust, The Heart Unit, Birmingham B4 6NH, UK. Tel: +447463618698. E-mail: huzeifa.elhedai@nhs.net
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Abstract

Introduction:

The association of a univentricular heart defect with common arterial trunk is extremely rare. There is a lack of population-based outcome studies reported in the literature.

Methods:

The hospital records, echocardiographic and other imaging modality data, outpatients’ records, operation notes, and other electronic data were reviewed. Patients were reviewed, and the final outcomes of surgery were observed.

Results:

Six cases (two males) with common arterial trunk presented over a 30-year period. Five had a complete unbalanced atrioventricular septal defect (83%) and one (17%) had tricuspid atresia associated with common arterial trunk. All had antenatal diagnosis. Two cases (33%) were excluded from initial surgical palliation due to Trisomy 21 in one and severe truncal valve regurgitation in one. Initial surgical palliation was performed in four cases (67%) at median age of 31 days (2–60) and consisted of disconnection and reconstruction of the pulmonary arteries and establishing controlled pulmonary blood flow. There were no early deaths. Conversion to cavopulmonary shunt was not possible in two due to severe airway problems in one and pulmonary arteries anatomy in one. They died at 11 and 16 months, respectively. Two patients (33%) underwent cavopulmonary shunt with 1 (17%) being alive at 18 months – 12 months after cavopulmonary shunt. The second patient proceeded to Fontan completion at 19 months but required catheter takedown 3 months later and died 3.5 years later.

Conclusions:

Univentricular hearts with common arterial trunk carry extremely poor short- to medium-term outcomes. This should inform antenatal and postnatal counselling and decision-making.

Keywords

Univentricular heartcommon arterial trunkcavopulmonary shuntFontan
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 7 , July 2023 , pp. 1097 - 1101
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Russell, HM, Jacobs, ML, Anderson, RH, et al. A simplified categorization for common arterial trunk. J Thorac Cardiovasc Surg 2011; 141: 645–653.CrossRefGoogle ScholarPubMed
Wilkinson, JL, Anderson, RH. Anatomy of functionally single ventricle. World J Pediatr Congenit Heart Surg 2012; 3: 159–164.CrossRefGoogle ScholarPubMed
Collett, RW, Edwards, JE. Persistent truncus arteriosus; a classification according to anatomic types. Surg Clin North Am 1949; 29: 1245–1270.CrossRefGoogle ScholarPubMed
de Leval, MR, Deanfield, JE. Four decades of Fontan palliation. Nat Rev Cardiol 2010; 7: 520–527.CrossRefGoogle ScholarPubMed
Tripathi, RR, Sridhar, A, Chidambaram, S. Unusual combination of hypoplastic left ventricle, atrioventricular septal defect with restrictive ventricular septal defect and common arterial trunk. World J Pediatr Congenit Heart Surg 2012;3: 396–398.CrossRefGoogle ScholarPubMed
Rice, MJ, Andrilenas, K, Reller, MD, McDonald, RW. Truncus arteriosus associated with mitral atresia and a hypoplastic left ventricle. Pediatr Cardiol 1991; 12: 128–130.10.1007/BF02238421CrossRefGoogle Scholar
Murdison, KA, McLean, DA, Carpenter, B, Duncan, WJ. Truncus arteriosus communis associated with mitral valve and left ventricular hypoplasia without ventricular septal defect: unique combination. Pediatr Cardiol 1996; 17: 322–326.CrossRefGoogle ScholarPubMed
He, D, Olivieri, LJ, Jonas, RA, Sinha, P. Palliation of truncus arteriosus associated with complete atrioventricular canal–results of single ventricle palliation. World J Pediatr Congenit Heart Surg 2015; 6: 663–666.CrossRefGoogle ScholarPubMed
Shaddy, RE, McGough, EC. Successful diagnosis and surgical treatment of single ventricle, truncus arteriosus. Ann Thorac Surg 1989; 48: 298–300.CrossRefGoogle ScholarPubMed
Fujimoto, Y, Tachi, M, Suehiro, S, Ito, M, Oda, T. A case of staged Norwood procedure for a unique form of truncus arteriosus, interrupted aortic arch with hypoplastic tricuspid valve and right ventricle and anomalous left coronary artery orifice; first reported case. Gen Thorac Cardiovasc Surg 2017; 65: 209–212.CrossRefGoogle ScholarPubMed
Panwar, S, Bradley, SM, Kavarana, MN. Truncus arteriosus and unbalanced complete atrioventricular septal defect: pulmonary protection in the neonate. Ann Thorac Surg 2012; 94: e151–e153.CrossRefGoogle ScholarPubMed