Abdelaal Mohamed, Dedieu Nathalie
Department of Paediatric Cardiology, Great Ormond Street Hospital, London, UK.
Eur Heart J Case Rep. 2022 Jun 28;6(7):ytac257. doi: 10.1093/ehjcr/ytac257. eCollection 2022 Jul.
A common arterial trunk is a relatively uncommon type of congenital heart defect. The anomaly is caused by an incomplete conotruncal septation. Arch anomalies, such as interruption, are associated with 10-20% of cases. We present a rare case of common arterial trunk with coarctation of the aorta and patent ductus arteriosus (PDA).
A term baby who was discovered to have a murmur on examination, for evaluation of the murmur an echocardiography was performed on Day 2 of life, which revealed the diagnosis of a common arterial trunk and coarctation of the aorta. The baby was given prostaglandin and intubated. Due to his poor general condition, he underwent an emergency pulmonary artery branch banding. He needed another 5 days in the intensive care unit to be stabilized before undergoing full repair.
Our patient has a common arterial trunk with a tricuspid competent truncal valve. The trunk is subdivided further into ascending aorta and main pulmonary artery. The pulmonary artery provided two branches and a PDA that connected to the descending aorta. The aortic branching pattern was as usual, there was an area of tight coarctation and posterior shelf just after the origin of the left subclavian artery before the descending aorta-PDA junction. The presence of coarctation may be considered as the left side of the spectrum of morphological changes toward the formation of aortic arch interruption (Type 4 Van Praagh).
共同动脉干是一种相对罕见的先天性心脏缺陷类型。这种异常是由圆锥干分隔不完全引起的。弓部异常，如中断，在10%-20%的病例中与之相关。我们报告一例罕见的共同动脉干合并主动脉缩窄和动脉导管未闭（PDA）的病例。
一名足月儿在体检时被发现有杂音，为评估杂音，在出生后第2天行超声心动图检查，结果显示为共同动脉干和主动脉缩窄。患儿给予前列腺素并插管。由于其一般状况较差，接受了紧急肺动脉分支束带术。在重症监护病房又需要5天才能稳定下来，然后进行全面修复。
我们的患者有一个共同动脉干，其动脉干瓣膜为三尖瓣功能正常。动脉干进一步分为升主动脉和主肺动脉。肺动脉有两个分支和一个连接降主动脉的动脉导管未闭。主动脉分支模式如常，在降主动脉-动脉导管未闭连接处之前，左锁骨下动脉起始处之后有一个紧密缩窄区域和后缘。主动脉缩窄的存在可被视为主动脉弓中断（Van Praagh 4型）形态学变化谱的左侧。
