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RxPG :: View topic - Truncus Arteriosus  
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Aim AIIMS May 2011

Truncus Arteriosus
hello this is geno.............
just poting the topic i felt imp..............
so here r they........................

the visitor should post atlesat one thing that u know regarding topic...........this will help all rxpgians...............

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Aim AIIMS May 2011

lets see....Truncus Arteriosus

In this defect, only one artery originates from the heart and forms both the aorta and the pulmonary artery. The truncus arises above a VSD that is almost always associated with this defect.

Aim AIIMS May 2011

The truncus receives low oxygen blood from the right ventricle and oxygen rich blood from the left ventricle. This mix of high and low oxygen blood is sent out to the body and to the lungs.

Aim AIIMS May 2011

oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, then is pumped through the pulmonary artery into the lungs where it receives oxygen.
Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, then is pumped through the aorta out to the body.
In truncus arteriosus oxygen-poor (blue) and oxygen-rich (red) blood mix back and forth through the ventricular septal defect. This mixed blood then flows through the common truncal vessel. Some of it will flow through the branch that becomes the pulmonary artery and on to the lungs, and some of the mixed blood will go into the aortic branch and continue to the body.
The mixed blood that goes to the body does not have as much oxygen as normal, and will cause varying degrees of cyanosis (blue color of the skin, lips and nailbeds).

Aim AIIMS May 2011

The following are the most common symptoms of truncus arteriosus. Each child may experience symptoms differently. Symptoms may include:

cyanosis (blue color of the skin, lips and nail beds)
pale skin
cool skin
rapid breathing
heavy breathing
rapid heart rate
congested breathing
disinterest in feeding, or tiring while feeding
poor weight gain

Aim AIIMS May 2011

Truncus arteriosus must be treated by surgical repair of the defects. Medical support may be necessary until the best time for the operation to take place. Treatment may include:

Medical Management — Many children will eventually need to take medications to help the heart and lungs work better. Medication that may be prescribed includes the following:
Digoxin -- A medication that helps strengthen the heart muscle, enabling it to pump more efficiently.
Diuretics -- The body's water balance can be affected when the heart is not working as well as it could. These medications help the kidneys remove excess fluid from the body.
ACE (angiotensin-converting enzyme) inhibitors -- Dilates the blood vessels, making it easier for the heart to pump blood forward into the body.
Infants may become tired when feeding, and may not be able to eat enough calories to gain weight. Options that can be used to ensure your baby will have adequate nutrition include:
High-calorie Formula or breast milk -- Special nutritional supplements may be added to formula or pumped breast milk that increase the number of calories in each ounce, thereby allowing your baby to drink less and still consume enough calories to grow.
Supplemental Tube Feedings -- Feedings given through a small, flexible tube that passes through the nose, down the esophagus and into the stomach, can either supplement or take the place of bottle feedings.
Infants who can drink part of their bottle, but not all, may be fed the remainder through the feeding tube. Infants who are too tired to bottle-feed may receive their formula or breast milk through the feeding tube alone.
Surgical Repair — Surgery is usually performed after the infant is two weeks old, but before the blood vessels in the lungs are overwhelmed by extra blood flow and become diseased. The operation is performed under general anesthesia, and involves the following:
The pulmonary arteries are detached from the common artery (truncus arteriosus) and connected to the right ventricle using a homograft (a section of pulmonary artery with its valves intact from a tissue donor). Occasionally, a conduit (a small tube containing a valve) is used instead of a homograft (human tissue valve).
The ventricular septal defect is closed with a patch.

Essentials of Medical Pharmacology By KD Tripathi
Extensively revised and updated chapters to include recently introduced drugs, published information and therapeutic practices.
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