Congenital heart defects can be life-threatening if not treated promptly. One of them istarterial vein. This condition is where a baby is born with only one blood vessel coming out of the heart, instead of two like other normal babies.
What causes this congenital heart defect and what can be done to treat and prevent it from happening?
Definition of Truncus Arteriosus
Quoting from the official website of the Centers for Disease Control and Prevention ,arterial trunk(TA) is a rare heart defect in which there is only one common blood vessel leaving the heart instead of two vessels (the main pulmonary artery and the aorta).
This condition occurs when the blood vessels leading out of the heart in a developing baby fail to separate completely during development, leaving a connection between the aorta and the pulmonary artery.
There are several types of TA, depending on how the arteries remain connected. There is also usually a hole between the two lower chambers of the heart (ventricles) called a ventricular septal defect (ventricular septal defect).
In babies without congenital heart defects, the right side of their heart pumps oxygen-poor blood through the pulmonary artery to the lungs, while the left side of the heart pumps oxygen-rich blood through the aorta to the rest of the body.
However, in babies with TA, low-oxygen blood and oxygen-rich blood mix as blood flows to the lungs and throughout the body. As a result, too much blood goes to the lungs and the heart works harder to pump blood throughout the body.
Source: Freepik
Additionally, instead of having an aortic valve and a pulmonary valve, babies with TA have only one common valve (the truncal valve) that controls the flow of blood out of the heart. This truncal valve is often abnormal.
The valves can thicken and narrow, which can block blood as it leaves the heart. They can also leak, causing blood leaving the heart to leak back into the heart across the valves.
This condition is a heart defect that is present from birth. Because babies with this defect may require surgery or other procedures soon after birth,arterial trunkconsidered a critical congenital heart defect (CCHD).
According toMayo Clinic, if not treated immediately it can be fatal. The success rate of surgery to correct this condition is generally quite high, especially if the repair is performed before the baby is 1 month old.
Symptom
Signs and symptomsarterial trunkoften appears in the first few days of life. Babies with TA usually have difficulty in the first few days of life because of the high amount of blood going to the lungs which makes the heart work harder.
Babies with TA may have symptoms such as:
- Blue color of the skin ( cyanosis ) or paleness
- Breathing problems (rapid breathing and/or shortness of breath)
- Heart palpitations
- Weak pulse
- Difficulty breastfeeding
- Poor growth
- Looks very tired or sleepy
Causes of Truncus Arteriosus
Source: Freepik
arterial trunkoccurs when the baby’s heart is developing in the womb. In most cases, the cause is still unknown.
Quoting fromMedlinePlus, in normal heart development the fetus initially has one large blood vessel coming out of the heart. However, during normal development this single very large vessel will divide into two parts.
One part becomes the lower part of the aorta, which is attached to the left ventricle. The other part becomes the lower part of the pulmonary artery, which is attached to the right ventricle. During this process, the ventricles will develop into two chambers separated by a wall (septum).
However, in babies born with TA, that one large blood vessel never finishes dividing into two separate vessels. The wall separating the two ventricles never closes completely, resulting in one blood vessel protruding from the heart, and a large hole between the two chambers.
Experts are still trying to determine why some babies develop this type of congenital heart defect . It’s possible that certain gene changes may play a role.
About 1 in 3 children with TA also have a chromosomal abnormality called DiGeorge syndrome. In addition to heart defects, this condition causes immune system problems and developmental delays.
Frequency of Occurrence
arterial trunkis a rare birth defect that occurs in about 1 in 10,000 births and affects boys and girls equally. Doctors diagnose about 250 cases of babies with this heart condition each year.
Risk Factors for Truncus Arteriosus
Source: Freepik
Genetics
A family history of congenital heart defects can increase a child’s risk of developing TA. Experts believe some cases of congenital heart defects are due to changes in their genes or chromosomes.
Mother’s Condition During Pregnancy
Congenital heart defects are also thought to be caused by a combination of genes and other risk factors such as things the mother is exposed to in her environment during pregnancy. Some of these include:
Diagnosis
arterial trunkcan be diagnosed during pregnancy or soon after the baby is born.
Prenatal Screening
During pregnancy, there are screening tests to check for birth defects and other conditions. Prenatal ultrasounds performed during pregnancy sometimes detect heart defects.
If the ultrasound shows a potential problem, your doctor may suggest a fetal echocardiogram. This test can show problems with the structure of the heart, such as one large blood vessel leading from the heart, and how the heart works with this defect.
Newborn Screening
If the doctor suspects the baby may be suffering fromtruncus arteriosusAfter examining the physical symptoms, echocardiography can be performed to confirm the diagnosis.
This condition can also be detected by newborn pulse oximetry screening. Pulse oximetry is a simple test to determine the amount of oxygen in a baby’s blood.
Low oxygen levels in the blood can be a sign of a congenital heart defect. Newborn screening using pulse oximetry can identify some babies with congenital heart defects such as truncus arteriosus before they show any symptoms.
Treatment of Truncus Arteriosus
Operation
Babies with TA require heart surgery within the first weeks of life. There are several procedures to correct this condition.arterial trunk, and the most common procedure is called the Rastelli operation.
This surgery usespatch(patch) to close the hole in the heart, then create a new aorta using a single existing blood vessel (truncus). After that the doctor will place an artificial tube (conduit) and artificial valves to create new arteries and pulmonary valves.
Drugs
Newborns may also need medications before surgery to help strengthen their heart muscles, lower blood pressure, and help their bodies get rid of extra fluid.
Children with TA are also at higher risk of developing a serious bacterial heart infection called endocarditis, so they may need to take antibiotics before undergoing a surgical procedure.
Extra Nutrition
Some babies with TA are too tired to feed and may not eat enough to gain weight.
To ensure your baby has a healthy weight, your doctor may prescribe a special high-calorie formula. In severe cases, your baby may need a feeding tube to help them feed.
Possible Complications of Truncus Arteriosus
Source: Freepik
The abnormal heart structure of TA causes the ventricles to not separate and all the blood comes out of one blood vessel, so that oxygen-rich blood and low-oxygen blood mix and produce blood that does not carry enough oxygen.
This will cause problems with blood circulation and other conditions such as:
- Respiratory problems
- High blood pressure in the lungs (pulmonary hypertension)
- Enlarged heart (cardiomegaly)
- Heart failure
Even if heart surgery is performed during infancy, other complications associated with truncus arteriosus can occur later in life such as:
- Progressive pulmonary hypertension
- Leaky heart valve (regurgitation)
- Heart rhythm disturbances (arrhythmia)
Prevention of Truncus Arteriosus
In most cases, congenital heart defects such asarterial trunkcannot be prevented. IfParentshave a family history of heart disease or have another child with a congenital heart disease,ParentsYou may want to consider talking to a genetic counselor and a cardiologist experienced in congenital heart defects before planning a pregnancy.
There are several preventive steps that can be taken when planning a pregnancy, such as:
- Vaccination before pregnancy to prevent dangerous diseases such as rubella
- Avoiding dangerous drugs
- Consume folic acid every day
- Managing blood sugar levels if you have diabetes
***
arterial trunkis a congenital heart defect that must be treated immediately by performing surgery so that the child remains safe and improves his quality of life. Hopefully this information can be useful!
Republished with permission from theAsianParent Indonesia
