Truncus Arteriosus in a newborn: the importance of the knowledge about the disease
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Abstract
Introduction: Truncus arteriosus, arterial trunk or persistent trunk, is
a congenital heart disease that results from a failure in the division of
the arterial trunk into the pulmonary and aortic trunk, causing a single
arterial trunk to pump blood to the pulmonary and systemic circulation,
making it a cyanogenic disease. The incidence of truncus arteriosus is 3 to
10 per 100,000 live births, and there are four types according to Van Praag:
A1, A2, A3, and A4. Objective: To describe the case of a female newborn
with truncus arteriosus type A1 Van Praag or Collett I, emphasizing the
importance of understanding this clinical condition for the diagnosis, care,
and treatment of newborns. Case Description: A 37 weeks and 3 days
female newborn, with uncomplicated childbirth, good breathing pattern,
heartbeats above 100 bpm, and oxygen saturation of 97%. The patient
presented a heart murmur of 3+/6+ at first, which evolved to 5+/6+ with
fremitus. The echocardiogram confirmed truncus arteriosus Van Praaghs
type A or Collett I. The patient was transferred to a cardiologic reference
center. Discussion: Truncus arteriosus is a rare condition in newborn care
services, which makes it difficult for health professionals to identify the
pathology and perform complementary tests. This delay in diagnosis
and treatment can significantly affect the prognosis, as children with
this anomaly have a high mortality rate in the first year of life. Therefore,
healthcare professionals must be aware of this condition and provide the
best course of treatment.
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References
1. Abel JS, Berg C, Geipel A, Gembruch U, Herberg U, Breuer J, Brockmeier K, Gottschalk I. Prenatal diagnosis, associated findings and postnatal outcome of fetuses with truncus arteriosus communis (TAC). Arch Gynecol Obstet. 2021, Dec; 304(6):1455-1466. doi: 10.1007/s00404 021-06067-x.
2. Anderson RC, Obata W, Lillehei CW. Truncus arteriosus: Clinical study of fourteen cases. Circulation. 1957;16(4), 586-598. ERA 16
3. Brasil. Portaria 1.727, de 11 de julho de 2017. Plano Nacional de Assistência à Criança com Cardiopatia Congênita. Ministério da Saúde. Diário Oficial da União, DF.
4. Castaneda AR. Truncus Arteriosus. Rev Ann Thorac Surg. 1989; 47:491-2.
5. Ginelliová A, Farkaš D, Farkašová Iannaccone S. Truncus arteriosus communis com sobrevivência até 46 anos: relato de caso. Soud Lek. 2015; 60 (3):37-39.
6. Gotsch F, Romero R, Espinoza J, Kusanovic JP, Erez O, Hassan S, Yeo L. Prenatal diagnosis of truncus arteriosus using multiplanar display in 4D ultrasonography. J Matern Fetal Neonatal Med. 2010 Apr; 23(4):297 307. doi: 10.3109/14767050903108206.
7. Kawasaki Y, Murakami Y, Ehara E, Oshitani T, Nakamura K, Yoshida Y, Suzuki T, Nishigaki K. A rare case of truncus arteriosus Van Praagh type A3: Prenatal diagnosis and postnatal management. J Cardiol Cases. 2019 May 23; 20(1):30-34. doi: 10.1016/j.jccase.2019.03.009.
8. Ministério da Saúde Departamento de Gestão e Incorporação de Tecnologias em Saúde da Secretaria de Ciência, Tecnologia e Insumos Estratégicos – DGITS/SCTIE Comissão Nacional de Incorporação de Tecnologias no SUS (CONITEC). Portaria 20, de 10 de junho de 2014. Incorporação da oximetria de pulso – teste do coraçãozinho na triagem neonatal. Acesso em: 13 fev. 2024. Disponível em: https://bvsms. saude.gov.br/bvs/saudelegis/sctie/2014/prt0020_10_06_2014.html
9. Ministério da Saúde Departamento de Gestão e Incorporação de Tecnologias em Saúde da Secretaria de Ciência, Tecnologia e Insumos Estratégicos – DGITS/SCTIE Comissão Nacional de Incorporação de Tecnologias no SUS (CONITEC). Portaria 3516, de 10 de dezembro de 2021. Mantém o procedimento Oximetria de Pulso como teste de Triagem Neonatal na Tabela de Procedimentos, Medicamentos, Órteses, Próteses e Materiais Especiais do SUS. Acesso em: 15 fev. 2024. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2021/ prt3516_23_12_2021.html
10. Moore KL, Persaud TVN, Torchia MV. Embriologia Clínica. 10th ed.: GEN Guanabara Koogan; 2016. 552 p.
11. Morhy SS et al. Posicionamento sobre Indicações da Ecocardiografia em Cardiologia Fetal, Pediátrica e Cardiopatias Congênitas do Adulto – 2020. Arquivos Brasileiros de Cardiologia. 2020 nov.; 115(5):987-1005.
12. Movahedian AH, Mosayebi Z, Sagheb S. Evaluation of Pulse Oximetry in the Early Detection of Cyanotic Congenital Heart Disease in Newborns. J Tehran Heart Cent. 2016 Apr 13; 11(2):73-78.
13. Naimo PS, Konstantinov IE. Surgery for Truncus Arteriosus: Contemporary Practice. The Annals of Thoracic Surgery. 2021, May; 111(5):1442-1450.
14. Poaty H, Pelluard F, André G, Maugey-Laulom B, Carles D. Truncus arteriosus communis: report of three cases and review of literature. Afr Health Sci. 2018 Mar; 18(1):147-156. doi: 10.4314/ahs.v18i1.19.
15. Sharma A, Priya S, Jagia P. Persistent truncus arteriosus on dual source CT. Japanese Journal of Radiology. 2016; 34(7), 486-493.
16. Williams JM, de Leeuw M, Black MD, Freedom RM, Williams WG, McCrindle BW. Factors associated with outcomes of persistent truncus arteriosus. Journal of the American College of Cardiology. 1999; 34(2), 545-553.
17. Zamith MM. Rastreamento das cardiopatias fetais: realidade em nosso meio. Rev Soc Cardiol Estado de São Paulo. 2011; 21(4):43-8 RSCESP 72594-1945.