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Truncus Arteriosus
Randy R. Richardson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Common arterial trunk (CAT)
          • Definitions

            • Common arterial vessel arising from heart, giving rise to aorta, pulmonary arteries (PAs), & coronaries
            • Classic radiographic appearance: Cardiomegaly, ↑ pulmonary vascularity, narrow mediastinum, right aortic arch
              • Truncus arteriosus is heart lesion most commonly associated with right aortic arch (30-40%)
            • Category: Cyanotic, cardiomegaly, ↑ pulmonary vascularity
            • Hemodynamics
              • Both ventricles connected to pulmonary & systemic circulation
              • Flow admixture across ventricular septal defect (VSD) & within truncus → cyanosis
              • Postnatal drop in pulmonary vascular resistance → relative ↑ in pulmonary blood flow → volume overload of pulmonary circulation
            • Frequently associated with absent thymus & parathyroid glands: DiGeorge syndrome

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Echocardiographic Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        Selected References

                                        1. Karakulak UN et al: Multimodality imaging of major aortapulmonary collateral arteries in type IV truncus arteriosus. Acta Cardiol. 70(3):361-2, 2015
                                        2. Koplay M et al: Truncus arteriosus: diagnosis with dual-source computed tomography angiography and low radiation dose. World J Radiol. 6(11):886-9, 2014
                                        3. Altun G et al: Crossed pulmonary arteries associated with persistent truncus arteriosus and right aortic arch on the three-dimensional computed tomographic imaging. Anadolu Kardiyol Derg. 13(5):E29, 2013
                                        4. O'Byrne ML et al: Morbidity in children and adolescents after surgical correction of truncus arteriosus communis. Am Heart J. 166(3):512-8, 2013
                                        5. Fogel MA et al: Cardiac magnetic resonance of the common arterial trunk and transposition of the great arteries. Cardiol Young. 22(6):677-86, 2012
                                        6. Diab K et al: Left hemitruncus associated with tetralogy of fallot: fetal diagnosis and postnatal echocardiographic and cardiac computed tomographic confirmation. Pediatr Cardiol. 31(4):534-7, 2010
                                        7. Frank L et al: Cardiovascular MR imaging of conotruncal anomalies. Radiographics. 30(4):1069-94, 2010
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Pathology

                                              • Clinical Issues

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Common arterial trunk (CAT)
                                                • Definitions

                                                  • Common arterial vessel arising from heart, giving rise to aorta, pulmonary arteries (PAs), & coronaries
                                                  • Classic radiographic appearance: Cardiomegaly, ↑ pulmonary vascularity, narrow mediastinum, right aortic arch
                                                    • Truncus arteriosus is heart lesion most commonly associated with right aortic arch (30-40%)
                                                  • Category: Cyanotic, cardiomegaly, ↑ pulmonary vascularity
                                                  • Hemodynamics
                                                    • Both ventricles connected to pulmonary & systemic circulation
                                                    • Flow admixture across ventricular septal defect (VSD) & within truncus → cyanosis
                                                    • Postnatal drop in pulmonary vascular resistance → relative ↑ in pulmonary blood flow → volume overload of pulmonary circulation
                                                  • Frequently associated with absent thymus & parathyroid glands: DiGeorge syndrome

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Echocardiographic Findings

                                                          • Angiographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              Selected References

                                                                              1. Karakulak UN et al: Multimodality imaging of major aortapulmonary collateral arteries in type IV truncus arteriosus. Acta Cardiol. 70(3):361-2, 2015
                                                                              2. Koplay M et al: Truncus arteriosus: diagnosis with dual-source computed tomography angiography and low radiation dose. World J Radiol. 6(11):886-9, 2014
                                                                              3. Altun G et al: Crossed pulmonary arteries associated with persistent truncus arteriosus and right aortic arch on the three-dimensional computed tomographic imaging. Anadolu Kardiyol Derg. 13(5):E29, 2013
                                                                              4. O'Byrne ML et al: Morbidity in children and adolescents after surgical correction of truncus arteriosus communis. Am Heart J. 166(3):512-8, 2013
                                                                              5. Fogel MA et al: Cardiac magnetic resonance of the common arterial trunk and transposition of the great arteries. Cardiol Young. 22(6):677-86, 2012
                                                                              6. Diab K et al: Left hemitruncus associated with tetralogy of fallot: fetal diagnosis and postnatal echocardiographic and cardiac computed tomographic confirmation. Pediatr Cardiol. 31(4):534-7, 2010
                                                                              7. Frank L et al: Cardiovascular MR imaging of conotruncal anomalies. Radiographics. 30(4):1069-94, 2010