A heart with three arterial trunks (tritruncal heart). Report of a case

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Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
06:02

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens

Published on: April 18, 2013

G Díaz-Góngora, M Quero-Jiménez, J Espino-Vela

    Pediatric Cardiology
    |January 1, 1982
    PubMed

    Insights

    A rare congenital heart defect features three separate arterial trunks: the aorta, main pulmonary artery, and a novel "intermediate trunk" supplying the right pulmonary artery. This finding is crucial for diagnosing absent or anomalous right pulmonary artery.

    Area of Science:

    • Cardiology
    • Developmental Biology
    • Pediatric Medicine

    Background:

    • Congenital heart diseases represent a spectrum of structural abnormalities present at birth.
    • Understanding the embryological origins of cardiac malformations is key to diagnosis and treatment.

    Observation:

    • A previously unreported congenital heart malformation in a 4 1/2-year-old girl.
    • The heart presented with three distinct arterial trunks: aorta, main pulmonary artery, and an "intermediate trunk" originating from the left ventricle.
    • Each artery possessed a semilunar valve at its origin, with completely separated lumens.

    Findings:

    • The aorta and intermediate trunk arose from the left ventricle; the pulmonary trunk arose from the right ventricle.
    • The intermediate trunk supplied the right pulmonary artery, and the main pulmonary trunk supplied the left pulmonary artery.
    • Both ventricular outflow tracts were normal, resulting in three arterial trunks from two outflow tracts.

    Implications:

    • The embryopathogenesis is hypothesized to involve double septation of the primitive arterial trunk and aortic sac, with truncal-conal septal malalignment.
    • This rare entity must be considered in the differential diagnosis of absent or anomalous right pulmonary artery.
    • Highlights the importance of detailed anatomical and embryological understanding in congenital heart disease.

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