Common arterial trunk
A common arterial trunk is one large vessel that drains from the heart through a single valve and provides coronary( cardiac) circulation, as well as blood flow into both( large and small) blood circulation. Other names: common trunk, persistent arterial trunk. The first description of this heart defect refers to 1864, the frequency of occurrence of the common arterial trunk is 2-3% of all congenital heart defects.
On emerging manifestations, children with this defect resemble patients with a defect of the interventricular septum: significant lag in physical development, repeated pneumonia, etc. The leading sign is shortness of breath with increased respiration to 50-100 per min. In cases of reduced blood flow through the lungs, shortness of breath is much less pronounced. Cyanosis of the skin with a common arterial trunk is different: it is minimal or absent with increased pulmonary blood flow, sharply expressed with minimal blood filling of the small circle of blood circulation. In recent cases, cyanosis is accompanied by deformation of the nails according to the type of "watch glass" and fingers like a "drumsticks."When examining in cases of an increase in the size of the heart, attention is drawn to the formation of the heart hump. When listening to the work of the heart, the characteristic noises are revealed.
Additional methods of examining the child include ECG, PCG( graphic recording of cardiac murmurs), chest radiography, ultrasound of the heart. Crucial importance in the diagnosis of tetralogy of Fallot have cardiac catheterization and angiocardiography.
The course of blemish is severe from the first days of life because of severe heart failure and blood overflow of the small circle of blood circulation. Cyanosis of the skin is determined by the degree of oxygen deficiency in the blood. Most children die in the first months of life, and only 20% survive the first year, and 10% survive until the 2-3rd decade.
Cardiac glycosides( digoxin) and diuretics give only a slight effect. It is recommended to carry out an operation to correct the defect. However, mortality from surgery at an early age exceeds 70%.In this regard, some clinicians offer to perform this operation only when the vice was an accidental find on the operating table.