When you look at your newborn baby, do you sometimes notice that his lips and fingertips are a little blue? Or does he have a hard time even after drinking milk? These can sometimes be signs of a congenital heart disease. It is normal for any mother or father to be scared when seeing something like this. Today we are talking about such a rare, but very important heart condition. That is Truncus Arteriosus.
Simply put, what is this Truncus Arteriosus?
Okay, let's understand this very simply. A healthy baby has two main blood vessels (arteries) coming out of its heart.
1. Pulmonary Artery: This carries oxygen-poor, impure blood from the heart to the lungs. In the lungs, this blood is purified by adding oxygen.
2. Aorta: This distributes oxygen-rich blood, purified in the lungs, from the heart to the entire body.
But in a baby with Truncus Arteriosus , instead of these two blood vessels, there is only one large blood vessel . Imagine, there is only one road where there should be two roads.
What happens is that oxygen-rich blood and oxygen-poor blood mix together. This mixed blood circulates throughout the baby's body. This puts an unbearable strain on the baby's heart and lungs. It also prevents the other organs in the body from getting the oxygen they need. Doctors consider this a critical congenital heart defect . Therefore, it needs to be treated immediately.
What are the symptoms that make me suspect that my baby has this condition?
These symptoms usually start to appear within the first few days after birth. Check to see if your baby has any of these symptoms.
| Symptom | A simple explanation about it |
|---|---|
| Blue or gray skin (Cyanosis) | A blue or gray color appears, especially around the baby's mouth and fingertips, because the body is not getting enough oxygen. |
| Excessive sleepiness | The baby is sleeping all the time. It seems difficult to wake him up. He looks very lifeless. |
| Difficulty breathing | The baby may seem to be breathing very fast. It may even feel like it's going into your chest. |
| Difficulty drinking milk | Even after drinking a little milk, the baby is very tired. He sweats, falls asleep while drinking, and stops drinking after a while. |
| Lack of weight gain | The baby is not gaining weight as it should for its age because it is unable to drink milk properly and the body uses up too much energy. |
| Rapid heartbeat and weak pulse | Even though the baby's heart may feel like it's beating fast when you put your hand on his chest, the pulse may be weak. |
The most important thing is, don't panic when you see one or two of these symptoms, but see a doctor immediately. The sooner the disease is diagnosed, the easier it is to treat.
Why does this happen to babies?
Scientists still don't know the exact reason for this. Most of the time, it's because the heart doesn't develop properly while the baby is growing in the womb. Normally, this single channel called the 'truncus' that exists in the embryo should later split into two parts and form two arteries. But in some babies, that division doesn't happen.
This is associated with certain genetic conditions. An example is DiGeorge syndrome . In addition, this risk may be increased by certain factors affecting the mother during pregnancy.
- The mother has diabetes.
- Viral infections like rubella.
- Use of alcohol or other drugs.
- Exposure to harmful chemicals like lead.
Other heart problems that can occur with this condition
Many babies with Truncus Arteriosus also have something else. That's a hole in the wall between the two lower chambers (atrium) of the heart. Doctors call this a Ventricular Septal Defect (VSD) . This hole also causes more mixing of clean and dirty blood.
How do doctors find this?
Often, doctors suspect this when a baby shows the above symptoms a few days after birth. Then, to confirm the disease, the main thing is to do an echocardiogram (echo) test. This is like an ultrasound scan of the heart. This can clearly see the shape of the heart, the blood vessels, and the way blood flows.
Sometimes, before symptoms appear, this may be suspected if the pulse oximetry test (which measures the oxygen level in the blood by attaching a small clip to the finger) performed on all babies at the hospital shows low oxygen levels.
Very rarely, this condition can be detected during ultrasound scans before the baby is born.
What are the treatments for this?
This may sound scary, but the truth is that babies with this condition need heart surgery within the first few weeks of birth. This is the only treatment. This surgery works by correcting the structure of the heart as much as possible.
In a procedure called a Rastelli repair , which doctors usually perform, the surgeon mainly does the following:
- The hole in the heart (VSD) is closed with something like a patch.
- The only existing large blood vessel (truncus) is being created as a new aorta.
- Using an artificial conduit and valve , a new pulmonary artery is created that carries blood to the lungs.
Will surgery be needed in the future?
Yes. This is very important to know. The artificial conduit that is placed during the first surgery does not grow with the baby. Therefore, as the baby grows, one or more surgeries will be needed in the future to replace the conduit. Your doctor will explain this to you from time to time.
How should I take care of my baby after the surgery?
After the surgery, your child will need to visit a cardiologist's clinic for the rest of his life.
- During childhood, you should receive treatment under a pediatric cardiologist .
- Once you reach the age of 18, you will be referred to an adult congenital cardiologist.
It is mandatory to go to these clinics because they are the ones who constantly check the child's heart function, perform the necessary tests, and decide when to perform the next surgery.
Can a baby live with this condition? Can they live a normal life?
This is the biggest question on every parent's mind.
Yes, absolutely. But only if the surgery is done in a timely manner. The survival rate after surgery is now very high (between 80% - 97%). But it also depends on other factors, such as the complexity of the baby's heart.
A 'normal life' is different for everyone. Some children will be able to run and play like other children. Others may feel a little tired when exercising. But with proper medical supervision, most people can go to school, study, work, and have a family life.
This journey is challenging, but you are not alone. Your doctors, nurses, and family will be a great source of strength for you.
The statistics or results you read online do not determine your child's future. They are just a summary of what we know right now. Trust your team of doctors to guide your child.
Take-Home Message
- Truncus Arteriosus is a serious congenital heart condition in which there is only one artery in the heart instead of two main arteries.
- Symptoms such as the baby's skin turning blue (cyanosis), difficulty breathing, and difficulty breastfeeding may appear in the first few days after birth.
- It is very important to see a doctor immediately if you notice any of these symptoms.
- Heart surgery is essential within the first few weeks after birth to save the baby's life.
- As the child grows, several more surgeries will be needed.
- It is very important to be under the supervision of a cardiologist throughout your life.
- With proper treatment and care, these children can also live long, good lives.
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