Persistent Truncus Arteriosus

PERSISTENT truncus arteriosus is one of the rarer congenital cardiac anomalies. Keith et al.1 cite the incidence to be less than 1 per cent of their congenital cardiac patients Abbott2 found 21 in her autopsy series of 1,000 cases and Wood3 had one in his clinical series of 900. Collett and Edwards4 reviewed, in an excellent study of 80 autopsied cases, the pathology of truncus arteriosus. The first description of this entity appeared in an article in 1864 by Buchanan,5 who described the clinical and postmortem findings in one of his patients, a 61/2-month-old, emaciated child who had a single vessel arising fronm the heart. The two coronary arteries arose normally. From the posterior aspect of this trunk, two pulmonary arteries took origin independently. The valve was composed of three cusps, one of which, however, was large and "looked much like two imperfect valves joined together." He further said "immediately beyond the origin of the pulmonary vessels, the aorta left the pericardium, gave off three large systemic vessels in the ordinary way and then continued curving over the right bronchus, as the thoracic aorta. " Studies on persistent truncus arteriosus, so far, have been based principally on autopsy material with relatively little clinical and physiologic information. The present study was undertaken to present the clinical, hemodynamic, and autopsy data on 19 such patients. A classification based on clinical findings, rather than pathologic features, is also proposed.