Truncus arteriosus (TA)

Truncus arteriosus explained

When the heart develops normally it has two main blood vessels that take blood away from the heart.

• The pulmonary artery takes blood low in oxygen from the heart to the lungs.
• The aorta takes blood high in oxygen from the heart to the body.

If you’re born with truncus arteriosus then you only have one blood vessel. This means blood high in oxygen and blood low in oxygen mix, and your lungs and body get less oxygen than they should. Because of this your heart has to work harder than normal.

Types of truncus arteriosus

There are different types of truncus arteriosus. The type you have will depend on where your blood vessels are in your heart. Your doctor can tell you more about your condition.

Truncus arteriosus and other conditions

Most people with truncus arteriosus will also have a hole between the bottom chambers of their heart (ventricles). This is called a ventricular septal defect (VSD).

You may also have a condition called 22q11 deletion syndrome. 22q11 deletion is a problem with your chromosome (part of your genes). It can mean you have learning difficulties, and you get ill more often as your body cannot fight infections as well.

Truncus arteriosus can also cause other conditions, including:

• heart failure
• irregular heart rhythm
• Eisenmenger syndrome
• pulmonary hypertension.

Symptoms of truncus arteriosus

Most people with truncus arteriosus have no symptoms except for a heart murmur.

This is a swishing noise created by the blood flowing the wrong way in your heart. Doctors can hear a heart murmur when they listen to your heart with a stethoscope.

Babies may appear healthy when they’re born but become more breathless over the first few weeks after birth.

Other signs and symptoms include:

• blue skin or lips
• shortness of breath
• not feeding or eating well
• sweating while feeding or eating
• feeling very tired (fatigue)
• irregular or extra heart beats.

If you have any of these symptoms or your symptoms are getting worse, speak to your doctor. Symptoms can be a sign that your heart is working harder than normal, and you may need treatment.

Diagnosing truncus arteriosus

Most people will be diagnosed shortly after they’re born or when they’re a child. Some adults may be diagnosed during a health check or if you’ve been having symptoms.

The most common test to diagnose truncus arteriosus is an echocardiogram.

You may also have:

• chest X-ray
• electrocardigram (ECG).

If you're diagnosed as an adult, you may need a cardiac MRI. Your doctors may also ask you to have a certain type of heart catheterisation test to look at the function of your heart in more detail. Speak to your doctors if you have questions about this.

These tests do not hurt. Speak to a healthcare professional if you have any questions or worries before having them.

Causes of truncus arteriosus

We do not know why truncus arteriosus happens. Not knowing what has caused your condition can be frustrating. It can help to find out more about the causes of congenital heart disease.

Treating truncus arteriosus

Truncus arteriosus is usually treated with open heart surgery when you’re a baby.

Before surgery you’ll be given general anaesthetic. This is like being asleep and you do not feel any pain.

The surgeon will work directly on your heart to fix your blood vessels. If you have a VSD they will close this first.

Then they will repair the way blood flows through your heart and arteries. This is done by changing the large vessel you have into an aorta. The aorta carries blood high in oxygen around your body.

They will then build a new pulmonary artery using an artificial tube, sometimes called a conduit. The pulmonary artery carries blood low in oxygen from the heart to the lungs.

If you need surgery for other heart conditions you’ll usually have these at the same time.

Scars after surgery

It's normal to worry about having scars after surgery but you're not alone.

Find information and support from the charity Changing Faces.

Recovery after surgery

Once your surgery or procedure is finished, you’ll be taken to a recovery area where you’ll receive specialist care. When you’re well enough you’ll be moved to a ward where you’ll recover.

You may be given medicine to take while you’re recovering. The hospital team will talk to you about this before you go home.

It’s normal to have questions about your recovery after surgery. Speak to your surgeon or nurse specialist about recovery, and any other questions you have.

• Read our information on recovery tips after surgery.

Will I need more surgery in the future?

You’ll usually need more surgery in the future. The type of surgery you have and when will depend on what heart conditions you have and your health.

Types of surgery you may need:

• heart valve repair
• heart valve replacement
• conduit repair, if your valve becomes too narrow.

Talk to your doctor about what surgery you may need in the future. They can explain why you may need more surgery and answer any questions.

Living with truncus arteriosus

It’s normal to feel anxious after being diagnosed. You may feel worried about your condition and how it will affect your life.

It’s important to go to your appointments, even if you feel well. Your doctors will check how your heart is working and can help answer any questions you have.

Your doctor will let you know how often they need to see you to make sure your heart is healthy.

• Read about the emotional impact of living with congenital heart disease.

Staying active

The exercise you can do will depend on what heart conditions you have, and how well your heart is working.

Speak to your healthcare team to find out what kind of exercise is best for you.

Family planning

If you’re pregnant or planning to have a family, it's important to speak to your doctor. They can discuss options with you, make sure you’re supported and get the right care.

Endocarditis

Endocarditis is a rare infection that causes inflammation of the valves and inner lining of the heart.

People with congenital heart diseases, including truncus arteriosus, have an increased risk of endocarditis. To reduce the risk of developing endocarditis, your doctor or dentist might recommend antibiotics before or after any surgery or procedures.

More information and support

Here are some ways you can get support.

• Read common questions about congenital heart disease. We talk about things like alcohol, mental health, preparing for surgery, and more.
• If you still have questions, speak to our cardiac nurses on our Heart Helpline by phone, callback, email or online chat (Monday to Friday, 9am to 5pm).
• You can also speak to others with heart conditions by joining a support group or online community.