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Severe pulmonary hypertension associated with common arterial trunk in a 9- year- old child

Saule Kabiyeva1, SeyedFarzad Jalali2, Farida Mindubayeva1

  • 1Karaganda Medical University, Karaganda, Kazakhstan.

Caspian Journal of Internal Medicine
|March 8, 2021
PubMed

Insights

Common arterial trunk (CAT) is a rare congenital heart defect. Delayed surgical intervention in children with CAT significantly worsens pulmonary hypertension and reduces treatment success.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Common arterial trunk (CAT) is a rare congenital heart defect, occurring in 3% of critical structural heart defects.
  • CAT can lead to early pulmonary hypertension and disability, with an 88% mortality rate in the first year of life.
  • This case highlights the challenges in managing CAT, particularly when surgical intervention is delayed.

Observation:

  • A 9-year-old boy with Type I CAT, diagnosed at 7 months and confirmed at 3 years via cardiac catheterization.
  • The patient presented with interventricular septal defect and pulmonary hypertension.
  • Parents initially refused surgical correction, leading to delayed treatment.

Findings:

  • The patient experienced progressive pulmonary hypertension and chronic arterial hypoxemia due to delayed treatment.
  • Current management includes a regimen of bosentan, sildenafil, captopril, kudesang, spironolactone, and aspirin.
  • Late diagnosis and surgical intervention in CAT cases are associated with poor outcomes.

Implications:

  • This case underscores the critical importance of timely diagnosis and surgical correction for common arterial trunk.
  • Delayed treatment significantly increases the risk of irreversible pulmonary hypertension and reduces surgical candidacy.
  • Early intervention is crucial for improving long-term prognosis in pediatric patients with CAT.
Abstract

Keywords:
Common arterial trunkCongenital heart diseasePulmonary hypertensionSerum serotonin

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