Explore the vast range of titles available.

Highlights of this retrospective study of adults with repaired truncus arteriosus (rTA) and contemporary cardiovascular magnetic resonance imaging studies (CMR) include:•CMR measures are stratified according to anatomic subtype in rTA•Right ventricular mass is increased in rTA as compared with normal•Right ventricular function and aortic size in rTA are associated with outcomes The cardiovascular magnetic resonance imaging (CMR) features of adults with repaired truncus arteriosus (rTA) are largely undefined. We sought to explore CMR characteristics in rTA and to identify associations between imaging findings and cardiovascular outcomes. Adults with rTA and CMR were identified and anatomic subtypes (1-4) were assigned (Collett and Edwards classification). CMR characteristics, clinical data at last follow-up and adverse cardiovascular outcome were recorded. Twenty-seven adults (19% male) were studied (median age at cardiovascular magnetic resonance 26 years [interquartile range 18 to 40]) over 5.2-year duration [interquartile range 2.5 to 7.5]. With the exception of mildly increased RV mass (30 ± 12 g/m2), cardiac chamber measurements were within the normal range. In CMR measurements, only pulmonary artery peak velocity differed in subtypes (highest in subtype 3, 318 ± 26 cm/s, p = 0.029). Number of cardiovascular interventions in adulthood was moderately correlated with left ventricular end-diastolic volume (r = 0.463, p = 0.015), left ventricular ejection fraction (r = 0.425, p = 0.027) and neoaortic root size (r = 0.398, p = 0.039). Cardiovascular events (nonmutually exclusive) in 5 of 27 patients (19%) included death (n = 1), heart failure (n = 1), ventricular tachycardia (n = 1), and atrial tachycardia (n = 3). Increased cardiovascular risk was associated with decreased right ventricular ejection fraction (odds ratio 1.153, confidence interval 1.003 to 1.326, p = 0.046) and smaller ascending aorta diameter (odds ratio 1.758, confidence interval 1.037 to 2.976, p = 0.036). In conclusion, decreased right ventricular ejection fraction and smaller ascending aorta on cardiovascular magnetic resonance were associated with adverse events in rTA.

Abstract Objectives Repair of common arterial trunk (CAT) involves establishing the right ventricular outflow tract (RVOT) using either a conduit or a direct right ventricle–pulmonary artery (RVPA) anastomosis (DA). Conduits offer a valved pathway but are limited by durability and availability. The comparative outcomes of these 2 techniques remain uncertain. This work assessed whether DA improves survival, reduces complications and reintervention outcomes compared to conduit repair. Methods PubMed, Web of Science, EMBASE, and Cochrane Central were searched for studies comparing conduit versus DA for RVOT reconstruction from February 20, 2025 to March 30 30, 2025. The primary outcome was early mortality; secondary outcomes included haemodynamics, recovery, and complications. Time-to-event data were reconstructed from Kaplan-Meier curves. Pooled hazard ratios (HRs), risk ratios (RRs), or mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Results Eleven studies (767 patients; 419 conduit, 348 DA) were included. Early mortality (RR = 0.61, 95% CI, 0.26-1.44, P = .220) and long-term survival (HR = 1.11, 95% CI, 0.61-2.02, P = .738) were similar. Reoperation was more frequent in the conduit group (HR = 1.77, 95% CI, 1.05-3.01, P = .034). Conduit repair required longer ventilation (MD = 3.44 days, P = .010) and hospitalization (MD = 4.77 days, P = .030), with comparable ICU stay and RVOT growth. Truncal valve insufficiency (RR = 0.13, P = .130 for truncal valve vs conduit) was similar in incidence following DA. Conclusions Conduit and DA repairs yield similar survival and postoperative complications in CAT, while DA offers fewer reoperations and faster recovery. Data from future prospective multicentre trials will support decision-making. Common arterial trunk (CAT), also known as truncus arteriosus, is a rare congenital cardiac anomaly, accounting for approximately 0.21%-0.34% of all congenital heart defects. Graphical abstract

Truncus arteriosus is a rare cyanotic congenital heart defect that involves septation failure of the heart’s main arterial outflow tract. Varying morphologies of the truncal valve and aorta have been reported; however, the ascending aorta is typically supplied via anterograde blood flow through the truncal valve. We present the first reported case of neonatal truncus arteriosus with the ascending aorta being supplied entirely by retrograde flow.

Early surgical management of common arterial trunk is well established and has good prognosis. Late diagnosis is less common. We reviewed late-diagnosed common arterial trunk management and prognosis for children in developing countries. We also discuss the need for prior catheterisation. Material and methods We reviewed all common arterial trunk patients managed by our humanitarian organization since 1996. A total of 41 children with common arterial trunk were managed at a mean age of 3 years old. The lack of adequate facilities in developing countries explains the late management. The decision to proceed with surgery was based on clinical and radiological symptoms of persistent shunt, particularly a high cutaneous saturation level, regardless of catheterization - not carried out systematically. Eight children had to be withdrawn and 33 (80.5%) received operation - mean saturation 91%. The postoperative course was marked by pulmonary arterial hypertension requiring specific treatment in 30% of cases. The operative mortality was 1/33. The 32 children returned home without treatment after a mean post operative stay of 49 days and were followed up (mean FU 3.4 years, none lost to follow-up). At last contact, 1 child died six months after surgery, 1 child had a massive truncal valve insufficiency, 5 had a significant stenosis of the RV-PA tube, and 2 have had further surgery for tube replacement. Late management and surgery of common arterial trunk is possible with good long-term results without prior hemodynamic examination up to an advanced childhood when signs of left-to-right shunt persist. A high saturation level (above 88%) seems to be a good operability criterion.

Arrhythmias in patients with congenital heart disease present a challenge to the care of these patients and can result in significant morbidity and mortality. Transposition of the great arteries and common arterial trunk are no exceptions. It is important to identify risk factors for arrhythmia development in the peri-operative period. The peri-operative arrhythmia burden may relate to the underlying congenital heart disease, haemodynamic perturbations, operative events, and potential residual lesions. In addition, these patients are at risk for developing arrhythmias later in life, and non-invasive and potentially invasive arrhythmia surveillance should be a routine part of the care of these patients. This article highlights important strategies to manage arrhythmia development and prevention in this patient population.

Primary care cardiology, also known as ambulatory or outpatient cardiology, for the longitudinal management of patients with common arterial trunk or with transposition of the great arteries is both poorly described and has limited evidence to justify its basis. This article discusses some of the various complications that these patients can develop, reviews the medical literature, and describes a framework for care of these complex patients from infancy to transition to adult congenital cardiac specialist care.

Truncus arteriosus, a rare and complex congenital heart disease, is hallmarked by a single great vessel (truncus) that arises over a large ventricular septal defect and provides both the pulmonary and systemic circulation. Pregnancy reports after repair for truncus arteriosus are scarce. Therefore, the maternal and offspring outcomes are unknown. We report the outcome of a pregnancy in an 18-year-old woman with repaired truncus arteriosus. Despite severe and symptomatic deterioration of truncal valve regurgitation, she successfully delivered a healthy child, and the valve function recovered within 2 weeks postpartum.

A 3.5-month-old girl was diagnosed with type I truncus arteriosus and severe pulmonary hypertension. We performed palliative bilateral pulmonary artery banding (right and left circumferences, 14 and 12 mm, respectively). Corrective repair for truncus arteriosus was then performed at 10 months of age. The good postoperative course in this patient demonstrates that palliative bilateral pulmonary artery banding is a useful surgical option for truncus arteriosus associated with pulmonary hypertension.

A three week old girl was admitted to hospital with severe congestive heart failure and cyanosis. Cross sectional and Doppler echocardiography and cardiac catheterisation showed a unique variant of truncus arteriosus with an intact ventricular septum. The trunk rose only from the left ventricle and was associated with a hypoplastic right ventricle with sinusoids to the right coronary artery.

This is the first documented case of truncus arteriosus communis with intact ventricular septum in which extensive clinical, haemodynamic, angiographic, and pathological data are available. Angiography suggested the presence of two discrete semilunar valves but necropsy showed a basically single semilunar valve. This case fills a gap in the spectrum of aorticopulmonary, truncal, and infundibular septal defects, and reinforces the belief that the essence of truncus arteriosus communis is a single semilunar valve, common to both ventricles, which need not be associated with the defects in the adjacent parts of the structural continuum.