TRUNCUS ARTERIOSUS TYPE I: A CASE REPORT

Abstract

Truncus Arteriosus (TA) is a rare congenital cyanotic heart disease which is characterized by single arterial trunk arising from heart which in turn gives rise to pulmonary trunk in various ways. TA constitutes 1.2% of all congenital heart malformations. According to Collett-Edwards classification there are 4 types of the disease. The most common variety is Type-1 which is characterized by short main pulmonary artery that originate from the trunk and give rise to right and left pulmonary arteries. Early surgical intervention is advised in all cases within first 2 month of life, in case of severe pulmonary hypertension, surgery is contraindicated.A full-term male newborn suspected with congenital cyanotic heart disease is referred to Sanglah Hospital. The patient had respiratory distress and looked cyanotic after breastfed. Physical examination revealed murmur on the chest auscultation. The chest X-ray showed prominent pulmonary vascular markings and unusually high hilar areas. The echocardiography showed truncus arteriosus type I, with moderate regurgitation, large pulmonary atresia, large ventricular septal defect, functionally single atrium, moderate mitral regurgitation, mild tricuspid regurgitaton. Patient was also diagnosed with heart failure ROSS II. The patient was given milk through orogastric tube, oxygen, and oral therapy for heart failure such as furosemide, spironolactone and digoxin. Another echocardiography was planned in the next 3 month. Pulmonary hypertension, heart failure, infective endocarditis and desaturation are recommended to be closely monitored.