Patient's question:
The baby had a color Doppler ultrasound and was found to have a common arterial trunk, ventricular septal defect, atrial septal defect, partial venous drainage abnormality, right ventricular wall thickening, and mild tricuspid valve regurgitation. The baby is now four and a half months old. Can surgery be performed?Doctor's answer:
The main lesions of the common arterial trunk are the systemic arteries, coronary arteries, and both pulmonary arteries, which all arise from a single arterial trunk at the base of the heart, hence the name "common arterial trunk." In the first week of life, the child may present with congestive heart failure, irritability, anorexia, and respiratory distress, pallor, and weakness. Cyanosis is uncommon.Guidelines:
Once the diagnosis is confirmed, surgery should be performed. If heart failure occurs, surgery can be delayed after 3 to 6 months of medical treatment, but it should not exceed 6 months. If severe heart failure cannot be controlled, a palliative procedure (e.g., Banding surgery) may be performed first to reduce pulmonary blood flow. If pulmonary vascular resistance is elevated and irreversible pathological changes occur in the lungs, surgery is not advisable. If the patient is older than 4 months, pulmonary vascular changes are often irreversible, but in some cases, pulmonary vascular resistance may not be high, and there may still be an opportunity for surgery.