![]() In addition coarctation of the aorta, anomalous pulmonary venous drainage, hypoplasia of the left lung, anomalous origin of subclavian arteries, single ventricle, absent right arteries-veins connection, hypoplastic right ventricle, tubular hypoplasia of the aortic arch, and double aortic anomaly may be rarely present. Patent foramen ovale and atrial septal defect are common. The disorder is accompanied by interrupted aortic arch or aortic coarctation in 14% of cases. 6% of cases are characterized by a persistent left superior vena cava (PLSVC) draining into coronary sinus. However, rare anomalous coronary take offs or courses may also be observed. The coronaries usually originate independently and have a normal course. There is an associated interrupted aortic arch in addition to Types 1 and 2 in Type A4. Type A3 is characterized by a branch of pulmonary artery (usually right) originating from the common trunk while other lung is perfused by either the pulmonary artery originating from the aortic arch or a vessel with an origin from ductus arteriosus or major aorto-pulmonary collaterals. In Van Praagh classification system, TA Type A1 and A2 are similar to Collet-Edwards TA Type 1 and Type 2, respectively. Type 4 disease is identified by the absence of pulmonary arteries the lungs are supplied by major aorto-pulmonary collateral arteries, which form an anatomic picture that may also be named as pulmonary atresia with VSD. In Type 3 TA no pulmonary truncus is present and the right and left pulmonary arteries branch from the truncus separately. Type 2 TA is characterized by the absence of the main pulmonary arterial trunk and the right and left pulmonary arteries originate together. According to Collett-Edwards classification, Type 1 disease is characterized by a single pulmonary arterial trunk that originates from the common trunk and gives off right and left pulmonary arteries. TA classification is made by two systems developed by Collett-Edwards and Van Praagh, both of which are based on the origins of the pulmonary arteries. Patients with TA typically have a large subarterial ventricular septal defect (VSD) located beneath the truncal valve. This condition may lead to valvular regurgitation, stenosis or both. ![]() The valve leaflets may be up to six in number. In TA, systemic pulmonary and coronary circulation originate from a single vessel that jointly emerges from the right and left ventricles by a truncal valve usually tricuspid, but quadricuspid and bicuspid valves have also been reported. Truncus arteriosus (TA) constitutes 1.2% of all congenital heart malformations. ![]()
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