MODERN APPROACHES TO THE DIAGNOSIS, SURGICAL CORRECTION, AND LONG-TERM MONITORING OF PATIENTS WITH COMMON ARTERIAL TRUNK
Introduction. Common truncus arteriosus (CTA) is a rare and severe congenital heart defect characterized by a single common vessel supplying both systemic and pulmonary circulations, leading to serious hemodynamic abnormalities. Without timely diagnosis and surgical intervention, approximately 80% of patients die within the first year of life. Modern imaging methods, such as echocardiography, CT, and MRI, allow for more precise identification of anatomical features, improving prognosis and treatment options. Advances in cardiac surgery have enabled early complete correction, though patients still require long-term monitoring due to the risk of complications. Research into modern approaches for the diagnosis and treatment of CTA is essential to improving the quality of life and survival rates for patients with this condition.
Aim: To investigate modern diagnostic methods and surgical correction techniques for common truncus arteriosus, assessing their effectiveness and impact on long-term treatment outcomes for patients with this rare congenital heart defect.
Search strategy: Key terms used to increase search accuracy included "common arterial trunk," "truncus arteriosus," "diagnostic methods", "echocardiography", "computed tomography", "cardiac catheterization", "magnetic resonance imaging", "surgical treatment", "long-term outcomes", "congenital heart defects." Inclusion Criteria: Publications with full-text articles available through open access or subscription resources; studies describing modern diagnostic methods (echocardiography, CT, MRI, cardiac catheterization) and surgical treatment of CTA; articles focused on the outcomes of surgical interventions and long-term results for patients with this defect. Publications in English and Russian from the last 20 years. Review articles, meta-analyses, and clinical studies with clear conclusions and results were prioritized. Exclusion Criteria: Duplicated publications, repeated articles, and resources with paid access if full texts could not be obtained; conference abstracts, promotional articles, short reviews, or materials without clear scientific conclusions; studies not directly related to the diagnosis and treatment of CTA, such as epidemiology or genetic research without a focus on clinical treatment methods. The search was not limited to specific time frames, as both recent studies and foundational works, such as the Collett and Edwards classification of 1949, were included to cover the evolution of CTA understanding from early anatomical descriptions to modern diagnostic and therapeutic methods. A total of 74 articles meeting the inclusion criteria were selected and analyzed.
Results and conclusions: Study results indicate that modern imaging methods, such as echocardiography, CT, and MRI, play a crucial role in the accurate diagnosis and treatment planning for common truncus arteriosus. These methods allow the identification of anatomical features, complications, and associated anomalies, which are critical for successful surgical correction. Early complete correction in the neonatal period significantly reduces the risk of complications, such as pulmonary hypertension and valve dysfunction. The use of biocompatible conduits and prosthetics also improves treatment outcomes, although regular monitoring is required. Long-term follow-up using high-precision imaging techniques helps to detect and correct late complications promptly, enhancing quality of life and increasing survival rates for patients with CTA.
Ғаниева Айгерім Анарбекқызы – докторант, НАО «Медицинский университет Астана»,тел.: 8 778 788 85 93, email: anarbekkyzy0805@gmail.com, https://orcid.org/0009-0006-7350-5685, г. Астана, Республика Казахстан;
Рахимжанова Раушан Ибжановна – д. м. н., заслуженный деятель Республики Казахстан, профессор, директор научно-исследовательского института им. Ж.Х.Хамзабаева, НАО «Медицинский университет Астана», тел.: 8 701 228 80 58, e-mail: rakhimzhanova01@rambler.ru, https://orcid.org/0000-0002-3490-6324, г. Астана, Республика Казахстан;
Даутов Тайрхан Бекполатович - д.м.н., асс.профессор, директор клинико-академического департамента Радиологии и ядерной медицины корпоративного фонда «University Medical Center», тел.:8 707 771 33 67, e-mail: tairkhan.dautov@gmail.com, https://orcid.org/0000-0002-5267-0108, г. Астана, Республика Казахстан;
Абдрахманова Жанар Сагатбековна - д.м.н., асс.профессор, заместитель директора научно-исследовательского института им. Ж.Х. Хамзабаева, НАО «Медицинский университет Астана», тел.: 8 701 536 00 31, e-mail: zhanna-ayan74@mail.ru, https://orcid.org/0000-0002-1890-0862, г. Астана, Республика Казахстан;
Альмусина Асель Кайратовна – докторант, НАО «Медицинский университет Астана», тел.: 8 747 330 4461, e-mail: assel.almussina@gmail.com, https//orcid.org/0000-0002-9031-3486, г. Астана, Республика Казахстан;
Гани Аружан Болатбеккызы – врач-резидент, ГУ "Больница Медицинского центра Управления делами Президента Республики Казахстан", тел: 8 747 123 0180, e-mail: ganiiaruzhan@gmail.com, https://orcid.org/0009-0005-2777-0376, г. Астана, Республика Казахстан;
Дуйсебаева Наргиза Абдикеримовна – врач радиоизотопной диагностики, ТОО «Национальный Научный Онкологический Центр», Центр внедрения радиационной онкологии и ядерной медицины, отделение радиоизотопной диагностики, тел.: 8 701 395 2093, email: d_nargiz@mail.ru, https://orcid.org/0009-0008-7356-6618, г. Астана, Республика Казахстан;
Имангельдина Макпал Сабитовна – врач-рентгенолог, ТОО «Национальный Научный Онкологический Центр», отделение лучевой диагностики, тел.: 8 778 962 2613, e-mail: imangeldina.ms@gmail.com, https://orcid.org/0000-0003-3658-9905, г. Астана, Республика Казахстан.
Бектыбаева Насихат Мударесовна – врач компьютерной томографии и магнитно-резонансной томографии, ТОО «Национальный Научный Онкологический Центр», отделение лучевой диагностики, тел.: 8 775 115 0581, email: nasihat84@mail.ru, https://orcid.org/0009-0002-7247-200X, г. Астана, Республика Казахстан.
1. Alsoufi B., Al-Radi O.O., Gruenwald C., et al. Results of truncus arteriosus repair with homograft conduits in neonates. Eur J Cardiothorac Surg, 2005. 28(3):32–41
2. Alsoufi B., Caldarone C. Long-term outcomes of truncus arteriosus repair with homografts. Ann Thorac Surg, 2005. 79(4):1398–1404
3. Alwi M., Nakata S., Satomi G. Use of right ventricle to pulmonary artery conduits in truncus arteriosus. J Thorac Cardiovasc Surg, 2001. 122(3):543–546
4. Anderson R.H., Macartney F.J., Shinebourne E.A., et al. Paediatric Cardiology." Edinburgh: Churchill Livingstone; 1987. Рр?
5. Backer C.L., Mavroudis C. Surgical management of truncus arteriosus in neonates and infants. Ann Thorac Surg, 1995. 60(2):547–554
6. Barron D.J., Kilby M.D., Davies B. et al. Hypoplastic left heart syndrome. Lancet, 2009. 374(9689):551–564
7. Belli E., Bonnet D., Sidi D., et al. Surgical outcome and reoperation rate after truncus arteriosus repair. J Thorac Cardiovasc Surg, 2005. 130(3):591–596
8. Belli E., Raffai C., Di Matteo D. Truncal valve management during truncus arteriosus repair. J Thorac Cardiovasc Surg, 2004. 127(4):1102–1108
9. Bonhoeffer P., Le Bret E., Piechaud J.F. Percutaneous pulmonary valve implantation in truncus arteriosus. Circulation, 2004. 110(6):93–98
10. Bove E.L., Mosca R.S., Schwartz S.M. Neonatal truncus arteriosus repair with homograft. J Thorac Cardiovasc Surg, 1994. 107(1):30–36
11. Bove E.L., Zeigler V., Devaney E.J. Strategies for reducing mortality in neonatal truncus arteriosus repair. Semin Thorac Cardiovasc Surg, 2001. 13(4):49–57
12. Bove T., François K., Van De Kerckhove K., et al. Assessment of ventricular performance in neonates and infants with truncus arteriosus after early primary repair. Eur J Cardiothorac Surg, 2004. 26(3):582–588
13. Brauner R., Laks H., Drinkwater D.C., et al. Pulmonary conduit replacement in truncus arteriosus repair. J Thorac Cardiovasc Surg, 1997. 114(5):932–940
14. Calderone C.A., Lee W.T., Pahl E., et al. Late results of truncus arteriosus repair with homograft conduits." J Thorac Cardiovasc Surg, 1997. 114(5):741–748
15. Caldarone C.A., McCrindle B.W., Veldtman G., et al. Independent factors associated with pulmonary homograft stenosis after the Ross procedure. Ann Thorac Surg, 2001. 71(4):1213–1218
16. Castillo J.G., Silvay G. Advances in pediatric cardiac anesthesia for congenital heart disease. Anesthesiol Clin, 2009; 27(4):655–666
17. Chang R.K., Chen A.Y., Klitzner T.S. Factors associated with age at operation for children with congenital heart disease. Pediatrics, 2000. 105(5):1073–1081
18. Chen J.M., del Nido P.J., Nath D.S., et al. Surgical repair of truncus arteriosus in infants: ten-year experience. J Thorac Cardiovasc Surg, 2001. 122(5):920–929
19. Constantinov I.E., Alexi-Meskishvili V., Williams W.G. Surgical management of truncus arteriosus with aortic arch obstruction. Ann Thorac Surg, 2003. 76(2):78–85
20. Cua C.L., Gaies M., Tabbutt S. et al. Impact of postoperative feeding practices on outcomes in congenital heart disease. Pediatr Cardiol, 2012. 33(1):44–51
21. Daebritz S.H., van Son J.A., Huth R.G. Neonatal truncus arteriosus repair: techniques and outcomes. Eur J Cardiothorac Surg, 2000. 17(4):495–501
22. Dearani J.A., Danielson G.K., Puga F.J., et al. Truncus arteriosus repair: surgical techniques and results. Mayo Clin Proc, 2000. 75(4):390–394
23. DiBardino D.J., Allison A.E., Vaughn W.K., et al. Intermediate outcomes of truncus arteriosus repair: a 15-year experience from a single institution. Ann Thorac Surg, 2001. 72(5):1630–1635
24. D'Cruz I.A., John S., Yacoub M., et al. "Management of truncal valve regurgitation." Eur Heart J, 1994. 15(9):1244–1249
25. Dodge-Khatami A., Schmid F.X., Tulevski I. Outcomes of truncus arteriosus repair with biological conduits. Ann Thorac Surg, 2003. 75(3):746–752
26. Einstein A.J., Moser K.W., Thompson R.C., et al. Radiation dose to patients from cardiac diagnostic imaging. Circulation, 2007. 116(11):1290–1305
27. Frank R., Parish V., et al. Cardiovascular MR imaging of conotruncal anomalies. RadioGraphics, 2010. 30(4):1069–1094
28. Freedom R.M., Benson L.N., Smallhorn J.F. Truncus arteriosus: diagnosis and management. Prog Pediatr Cardiol, 2005. 22(1):47–54
29. Giroud J.M., Jacobs J.P. Conotruncal anomalies: embryology and surgical management. Ann Thorac Surg, 1993. 55(3):543–549
30. Habets J., Symersky P., van Herwerden L.A., et al. Prosthetic heart valve assessment with multidetector-row CT: imaging characteristics of 91 valves in 83 patients. Eur Radiol, 2011. 21(7):1390–1396
31. Hawkins J.A., Feltes T.F., Nakanishi T. Management of severe truncal valve insufficiency. Ann Thorac Surg, 1994. 58(5):1460–1464
32. Ilbawi M.N., Idriss F.S., DeLeon S.Y., et al. Conduit repair for truncus arteriosus: long-term results. Ann Thorac Surg, 1986. 42(5):477–482
33. Ikai A., Kusakabe T., Sakamoto N., et al. Long-term outcomes in patients with truncus arteriosus. Circ J, 2008. 72(3):442–447
34. Jacobs J.P., Elliott M.J., Quintessenza J.A., et al. Congenital Heart Surgery Nomenclature and Database Project: truncus arteriosus. Ann Thorac Surg, 2000. 69(4). рр?
35. Jacobs J.P., Mavroudis C., Quintessenza J.A., et al. The Society of Thoracic Surgeons Congenital Heart Surgery Database: 2018 update on outcomes and quality. Ann Thorac Surg, 2018. 105(2):684–692
36. Jacobs J.P., Mavroudis C., Quintessenza J.A., et al. A review of the Society of Thoracic Surgeons Congenital Heart Surgery Database: 2007. Ann Thorac Surg, 2008. 85(3):22–28
37. Jonas R.A., Colan S.D., Mayer J.E. Surgical repair of truncus arteriosus with interrupted aortic arch. J Thorac Cardiovasc Surg, 1994. 108(6):1034–1040
38. Kang S.L., Benson L. Recent advances in cardiac catheterization for congenital heart disease. F1000 Res, 2018. 7:370
39. Karl T.R., Weintraub R.G., Brizard C.P., et al. Late outcomes of truncus arteriosus repair. Ann Thorac Surg, 2001. 71(5):1530–1536
40. Katzberg R.W., Lamba R. Contrast-induced nephropathy after intravenous administration: fact or fiction? Radiol Clin North Am, 2009. 47(5):789–800
41. Kim Y.J., Lee C.H., Sohn Y.H. Clinical outcomes of truncus arteriosus repair in neonates. Circ J, 2004. 68(5):512–516
42. Kirklin J.K., Blackstone E.H. Cardiac Surgery: Morphology, Diagnostic Criteria, Natural History, Techniques, Results, and Indications. Churchill Livingstone; 1993. №?,рр?
43. Lacour-Gayet F, Bruniaux J, Serraf A, et al. Truncus arteriosus repair with homograft conduits in infants. J Thorac Cardiovasc Surg, 1994. 108(4):813–820
44. Lacour-Gayet F., Piot J.D., Batisse A. Current status of truncus arteriosus repair in neonates. Eur J Cardiothorac Surg, 2006. 30(6):895–901
45. Lange R., Hörer J., Vogt M., et al. Long-term follow-up after neonatal truncus arteriosus repair. J Thorac Cardiovasc Surg, 2004. 128(5):880–885
46. Levy D.M., Veasy L.G., de Vries S., et al. Long-term results of truncus arteriosus repair. J Am Coll Cardiol, 1993. 21(5):1195–1201
47. Liava’a M., Barron D.J., Bellsham-Revell H. Long-term outcomes after neonatal truncus arteriosus repair. Eur J Cardiothorac Surg, 2009. 35(3):508–513
48. Mavroudis C., Backer C.L., Muster A.J., et al. Surgical management and outcomes in truncus arteriosus. Ann Thorac Surg, 2008. 85(2):453–460
49. McElhinney D.B., Reddy V.M., Tworetzky W., et al. Pulmonary valve replacement after repair of truncus arteriosus. J Thorac Cardiovasc Surg, 2000. 120(4):909–916
50. Michielon G., Stellin G., Rizzoli G., et al. Primary repair of truncus arteriosus in the first month of life: early and late results. Ann Thorac Surg, 1997. 64(2):563–571
51. Niwa K., Terai M., Tatewaki H. Long-term prognosis and reintervention rate for truncus arteriosus. Circ J, 2004. 68(7):632–636
52. Partridge J.B., Shore D.F., Lincoln C., et al. Long-term follow-up of the aortic homograft in the right ventricular outflow tract. J Thorac Cardiovasc Surg, 1983. 85(1):127–133
53. Patel A., Hickey E., Lalu M., et al. Perioperative outcomes of truncus arteriosus repair. Ann Thorac Surg, 2010. 90(5):72–80
54. Pettersen M.D., Du W., Skeens M.E., et al. Adolescent echocardiographic Z scores for assessment of dilated cardiomyopathy. Pediatr Cardiol, 2008. 29(5):999–1002
55. Petrossian E., Reddy V.M., McElhinney D.B. Surgical intervention for truncus arteriosus with complex anomalies. J Thorac Cardiovasc Surg, 1997. 113(3):530–538
56. Pizarro C., Malec E., Maher K.O., et al. Early and mid-term outcomes after truncus arteriosus repair in neonates and infants. Ann Thorac Surg, 2006. 81(2):49–56
57. Prêtre R., Tamisier D., Bonnet D., et al. Outcomes after truncus arteriosus repair in neonates. Ann Thorac Surg, 2004. 78(6):2086–2091
58. Puga FJ, Leoni FE, Julsrud PR, et al. "Pediatric truncus arteriosus repair: long-term survival." J Thorac Cardiovasc Surg, 1996; 111(4):857–865
59. Rajasinghe H.A., McElhinney D.B., Reddy V.M. Surgical management of truncus arteriosus in neonates. Ann Thorac Surg, 1998. 65(1):66–70
60. Reller M.D., Strickland M.J., Riehle-Colarusso T., et al. Prevalence of truncus arteriosus and associated risk factors. Circulation, 2008. 117(1):234–241
61. Restivo A., Piacentini G., Placidi S. et al. Cardiac outflow tract: a review of some embryogenetic aspects of the conotruncal region of the heart. Anat Rec A Discov Mol Cell Evol Biol, 2006. 288(9):936–943G
62. Santoro G., Bigazzi M.C., Palladino M.T., et al. Truncus arteriosus repair in neonates: the importance of early intervention. Eur J Pediatr Surg, 2008. 18(5):341–347
63. Shin'oka T., Shum-Tim D., Ma P.X. Tissue engineering for heart valve replacement. Ann Thorac Surg, 2002. 73(4):1402–1408
64. Sinzobahamvya N., Arenz C., Urban A.E. Results of surgical repair of truncus arteriosus: long-term outcomes. Thorac Cardiovasc Surg, 1995. 43(1):52–56
65. Thiene G., Bortolotti U., Laborde F., et al. Histologic findings of human aortic valve homografts used as aortic valve substitutes. Am J Cardiol, 1984. 54(1):171–176
66. Tsai I.C., Chen M.C., Jan S.L. et al. Neonatal cardiac multidetector row CT: how we do it. Pediatr Radiol, 2008. 38(4):438–451
67. Tweddell J.S., Hoffman G.M., Mussatto K.A., et al. Improving outcomes in neonates with truncus arteriosus. Semin Thorac Cardiovasc Surg, 2006. 11(1):33–41
68. Urban A.E., Malec E., Moser M., et al. The use of pericardial and PTFE conduits in neonatal truncus arteriosus repair. Pediatr Cardiol, 2002. 23(4):108–115
69. Urban A.E., Sinzobahamvya N., Brecher A.M., et al. Homograft repair in neonates and infants with truncus arteriosus. Ann Thorac Surg, 1998. 66. Рр?
70. van Son J.A., Mohr F.W., Anderson R.H. Anatomy of truncus arteriosus. Thorac Cardiovasc Surg, 1990. 38(5):293–296
71. von Oppell U.O., Schlosser B., Levin S.E. Valve-sparing operation in truncus arteriosus. Ann Thorac Surg, 1996. 62(6):1685–1689
72. Walters H.L., Mavroudis C., Tanel R.E. Strategies for truncus arteriosus repair in neonates. Ann Thorac Surg, 1998. 66(4):1255–1259
73. William W.G., Freedom R.M., McCrindle B.W. Truncus arteriosus repair and outcomes in the modern era. J Thorac Cardiovasc Surg, 2006 131(4):914–920
74. Yamasaki Y., Kamitani T., Sagiyama K., et al. Model-based iterative reconstruction for 320-detector row CT angiography reduces radiation exposure in infants with complex congenital heart disease. Diagn Interv Radiol, 2021. 27(1):42–49
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Ganiyeva A.A., Rakhimzhanova R.I., Dautov T.B., Abdrakhmanova Zh.S., Almussina A.K., Gani A.B., Duisebayeva N.A., Imangeldina M.S., Bektybayeva N.M. Modern approaches to the diagnosis, surgical correction, and long-term monitoring of patients with common arterial trunk // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (1), pp. 196-207. doi 10.34689/SH.2025.27.1.023Похожие публикации:
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