Related Experiment Video
Updated: Aug 19, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Current status of the surgical treatment of truncus arteriosus
Insights
Surgical correction for persistent truncus arteriosus is feasible in select patients. Successful outcomes depend on favorable anatomy, adequate pulmonary arteries, and absence of irreversible pulmonary vascular disease, guiding a new management protocol.
Area of Science:
- Cardiology
- Pediatric Surgery
- Congenital Heart Disease
Background:
- Persistent truncus arteriosus (PTA) is a complex congenital heart defect.
- Surgical correction is increasingly successful in patients with favorable anatomy.
- The presence of irreversible pulmonary vascular disease is a critical limiting factor.
Purpose of the Study:
- To review current surgical approaches for persistent truncus arteriosus.
- To present a management protocol based on clinical experience and literature review.
- To evaluate the role of different reconstructive techniques and adjuncts.
Main Methods:
- Review of clinical experience with surgical correction of PTA.
- Analysis of published literature on PTA management and outcomes.
- Evaluation of reconstructive materials, including homografts and synthetic prostheses.
- Consideration of surgical adjuncts like pulmonary artery banding and shunts.
Main Results:
- Surgical correction is possible with reasonable pulmonary arteries and without irreversible pulmonary vascular disease.
- Systemic-pulmonary artery shunts and pulmonary artery banding are viable adjuncts.
- Deep hypothermia and circulatory arrest may enable earlier interventions.
- Synthetic prostheses with heterograft valves are favored over aortic homografts for reconstruction.
Conclusions:
- Surgical correction of persistent truncus arteriosus is achievable with careful patient selection and surgical technique.
- The choice of reconstructive material, particularly favoring synthetic prostheses, is important.
- A structured management protocol can optimize outcomes for patients with PTA.
Abstract:
Persistent truncus asteriosus is now correctable surgically in patients with favorable anatomy. Given pulmonary arteries of reasonable size arising from any source, successful correction is possible so long as irreversible pulmonary vascular disease has not occurred. Although the majority of children with this defect demonstrate increased pulmonary blood flow, systemic-pulmonary artery shunts can be used. Also, banding of the pulmonary artery, followed subsequently by successful total correction, has been described. Recent reports of a few successful total corrections in infancy, performed with the aid of deep hypothermia and circulatory arrest, may modify the current approach. Although the majority of the reported corrections have involved aortic homograft reconstruction of the pulmonary artery, we strongly favor a synthetic prosthesis containing a heterograft valve. Based upon our clinical experience and this review of the literature, a suggested management protocol is presented.
