Truncus arteriosus 5th decade transesophageal and transthoracic echocardiogram features

Persistent truncus arteriosus in the 5th decade is a rare entity as the only physical anomaly. Truncus arteriosus consists of a single great arterial trunk with the systemic, pulmonary, and coronary circulation, with no atretic aortic or pulmonary vessel. The complex cardiac anatomy can be delineated with transesophageal and transthoracic echocardiography, as is illustrated the case of our patient, who was diagnosed in infancy, at 5 months of age. This is the oldest documented case report of Type 3 truncus arteriosus with balanced biventricular anatomy, whose survival was secondary to an innate severe branch pulmonary artery stenosis. <Learning objective: This case report documents the echocardiographic features of a rare congenital cardiac anatomy of truncus arteriosus where survival for the majority is only in infancy but those with pulmonary hypertension can survive to their 4th decade. This is the oldest documented case report of Type 3 truncus arteriosus with balanced biventricular anatomy and one of the eight cases documented survival after 30 years of age. The transthoracic and transesophageal echocardiographic images are the focused feature in this paper, confirming clearly defined structural anatomy in complex structural congenital heart disease.>.