A Rare Presentation of Common Arterial Trunk with Intact Ventricular Septum

Diane E Spicer,Thora S Steffensen

doi:10.3390/jcdd7040043

Abstract

Common arterial trunk is a rare anomaly on its own, but with an intact ventricular septum it is extremely rare. An unexpected finding at autopsy prompted a review of the literature and a review of the developmental considerations associated with the outflow tracts. The case presented was an intrauterine fetal death at 37 weeks gestation. At autopsy, the only anatomic abnormalities were pulmonary dominant common arterial trunk with an intact ventricular septum, ventriculo-arterial septal defect, coarctation and widely patent arterial duct. A review of the literature and the developmental concepts related to the outflow tracts of the developing heart demonstrate the rare nature of this particular variation of common arterial trunk.

Highlights

Utilizing pure descriptive terms proves to be the most sufficient method in defining the anatomy of a common arterial trunk
The initial classification put forth by Collett and Edwards [1], and subsequently modified by Van Praagh and Van Praagh [2], leaves gray zones within the alpha-numeric classifications, Van Praaph and Van Praagh did recognize that a common arterial trunk could co-exist with an intact ventricular septum
The case presented by Alves and Ferrari [8] showed a common arterial trunk arising exclusively from the right ventricle, with a hypoplastic left ventricle and an absent left atrioventricular connection

Summary

Introduction

Utilizing pure descriptive terms proves to be the most sufficient method in defining the anatomy of a common arterial trunk. Zeevi et al [7], in contrast, presented a case with a hypoplastic right ventricle, intact ventricular septum, and a common arterial trunk arising exclusively from the left ventricle. A most interesting arrangement is described by Tsang et al [9] Their patient had a ventriculo-arterial septal defect, with separate aortic and pulmonary valves, but with a common ventriculo-arterial junction. The intermediate component demonstrates its own independence with separate aortic and pulmonary valvar components arising on either side of the fibrous partition at the common ventriculo-arterial junction. This leaves the door open to look even deeper into the way in which the outflow tracts develop, and presents yet another variation in this group of exceedingly rare lesions. Comparisons between a common ventriculo-arterial junction and a common atrioventricular junction will be drawn

Case Report

Findings

Discussion

Conclusions