What are the complications associated with truncus arteriosus?
Children who are born with truncus arteriosus may have an excessive amount of blood flowing to the lungs, which can cause congestive heart failure. Symptoms of congestive heart failure can include:
- Shortness of breath.
- Wheezing or noisy breathing.
Other complications associated with truncus arteriosus include respiratory and circulatory problems, including the following:
- High blood pressure in the lungs (pulmonary hypertension) and breathing problems: The excessive amount of blood flowing into the lungs and constriction (tightening) of blood vessels can cause respiratory problems.
- Enlargement of the heart (cardiomegaly): Excessive blood flow to the lungs and heart put additional stress on the heart, which may cause it to increase in size and weaken.
- Heart failure: Stress on the heart caused by a greater workload, along with reduced oxygen supply, can lead to heart failure.
How is truncus arteriosus treated?
Truncus arteriosus is treated with surgery to repair the heart defect. Surgery is usually performed in the neonatal period (1-2 weeks after birth).
During the surgery, the ventricular septal defect (hole in the wall between the right and left ventricles) is closed with a patch. The upper part of the pulmonary artery is separated from the single common artery (truncus arteriosus). Then a tube or conduit and a valve are inserted to connect the right ventricle of the heart with the pulmonary artery. The single large vessel is reconstructed to create a new aorta. The surgeon might also repair the truncal valve, if necessary.
Before the surgery is performed, your child may receive medications such as diuretics and digoxin to regulate the function of the heart and lungs. Digoxin improves the strength of heart muscle contractions, helping the heart to pump blood more efficiently. Diuretics help remove extra fluid from the body, which often occurs in cases of heart failure.
What happens after the surgery?
Your child will have to spend several days in the hospital after the surgery. He or she may need pain medications such as ibuprofen or acetaminophen. Your child may require more sleep or rest after the operation, or may tire more easily. Full recovery usually takes a few weeks.
Your child may need additional surgery later to replace the conduit or tube that has been implanted to connect the right ventricle and pulmonary artery. The conduit usually has to be replaced 2 or 3 times while the child is growing, to keep the blood flow from being blocked. These surgeries usually require a hospital stay of less than 1 week.
Some medical procedures are being developed that use a cardiac catheter instead of a replacement conduit in order to avoid the need for traditional surgery. There is also a chance that the truncal valve might leak. If this occurs, surgery to repair the leaky valve should be performed within five to seven years of the initial surgery to prevent serious heart damage.