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Radiology
Common Arterial Trunk
Built from Obstetric Imaging
What’s inside
9 sections · 55 slides
Overview
- What this deck covers
What a common arterial trunk is
One valve, one vessel, both pumping chambers
- Normally the heart has two exits
- The definition, in plain words
- One trunk sitting over both ventricles
- 1%–2%
- Uncommon, but never minor
What tends to come with it
Genes, other heart faults, and problems outside the heart
- Genetic testing matters here
- Testing for the 22q11 deletion
- Other heart problems travel with it
- Problems outside the heart are common
Why it happens
A separation that never completed
- How the single trunk comes about
- The valve is usually abnormal
- The hole underneath the trunk
- A hole between the two ventricles
- The coronary arteries are often unusual
- Everything hangs off one vessel
Naming the types
Two classifications, both built around the lung arteries
- Why there are two naming systems
- Collett and Edwards Classification for Common Arterial Trunk
- Van Praagh’s Classification for Common Arterial Trunk
- What each system adds
How it shows up
Often quiet before birth, urgent after it
- Before birth it can be silent
- How a leaky valve ends in hydrops
- After birth the clock starts
Finding it on ultrasound
View by view, then colour Doppler
- The scanning sequence
- A normal-looking four-chamber view
- The view that gives it away
- One trunk over a large septal hole
- Trunk straddling the septal defect
- Both ventricles feed the same vessel
- The truncal valve in short axis
- Colour Doppler across the truncal valve
- The finding that clinches it
- Where the branches come off the trunk
- Pulmonary branch arising from the trunk
- Forward flow into the lung artery
- Head and arm vessels off the same trunk
- The three vessels and trachea view
- When the branches will not show
- Classic signs
Telling it apart
The look-alike is pulmonary atresia with a VSD
- Two answers to the same picture
- The hardest differential
- Normal heart beside tetralogy of Fallot
What happens next
Before birth, at delivery, and in theatre
- Before birth
- Planning the delivery
- When surgery happens
- What the operation does
- 65%–80%
- What makes the outlook worse
- What the referring physician needs to know
- Key points
- Suggested readings
- References
- References (continued)
- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition