Conditions caused by congenital malformations are life-threatening. They are fraught with critical states. The general arterial trunk is a pathology, which experts attribute to severity by the first category.
Early diagnosis, preferably still in the perinatal period, will allow you to prepare well for care, carefully plan it. This approach will improve the patient's prognosis of the problem. So, let's understand that this is an abnormality of the circulatory system, a common arterial trunk.
Features of the disease
Wrong structure: instead of two outgoing from each ventricular trunk - one arterial trunk, which receives blood from the ventricles, where it is mixed. The mainline is located more often above the partition in the place of its defect.
In the perinatal period the child does not suffer from abnormal disorders in the structure of the heart. He after birth acquires a cyanotic coloring of the skin, other signs develop: shortness of breath, sweating.
The body experiences oxygen starvation. The right half of the heart is overloaded, because because of the communication of the ventricles, the same pressure is obtained in them.
It is possible to help the child if the pathology is surgically corrected in time. If not treated, then a poor prognosis.
Irreversible processes in the lungs over time make it impossible to correct the operation. In this case, a lung and heart transplant can be saved.
Next, we will consider the classification of the common arterial trunk.
Scheme of development of the common arterial trunk
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Forms and classification
The location of the pulmonary artery, including its branches, determines different forms of pathology.
- The right and left pulmonary arteries are dislocated from the back of the trunk. They come out of the common trunk and are located next to each other.
- Pulmonary arteries are attached to the trunk, located on the sides.
- The trunk is divided into the aorta and the pulmonary short artery. The right and left arteries emerge from the pulmonary common vessel.
- When there are no pulmonary arteries, and the lungs are supplied with blood through the arteries of the bronchi. Experts now do not refer this pathology to the type of a common arterial trunk.
Causes of
A child develops a vice during his perinatal life. In the first three months there is a detailed cardiovascular system. This period becomes the most vulnerable to harmful influences that can help the appearance of anomalies.
To harmful factors during child bearing include:
- exposure to radiation,
- nicotine,
- contact with harmful chemicals,
- alcohol, narcotic substances;
- medication should be taken after consultation with a specialist;
- irregular organ formation can occur if a prospective mother during pregnancy becomes ill:
- influenza,
- autoimmune diseases,
- rubella,
- by other infectious diseases;
- from chronic diseases represents a risk of diabetes mellitus;a pregnant woman suffering from this disorder, it is necessary to be under the close supervision of the endocrinologist.
Symptoms of
The vice creates a situation of chronic lack of oxygen in the blood. This manifests itself in symptoms.
The patient has:
- sweating,
- there is a significant increase in respiration, especially during an increase in body burden;
- skin is of varying degrees, depending on the depth of the problem, bluish color,
- reduced tone,
- spleen and liver can increase,
- the child begins to noticeably lag behind in physical development,
- increased heart size can cause chest deformation in the form of a heart hump,
- can change the shape of the fingertips, their thickening;
- pathology causes deformation of the nails in the form of "watch glass".
Diagnosis of
A newborn can be with already suspected abnormalities in health if fetal examinations were performed. Early diagnosis allows you to prepare in advance and plan assistance to the child.
If a newborn has symptoms: fatigue, shortness of breath, cyanosis, then the specialist appoints a follow-up examination. It can include procedures:
- Phonocardiography - the device records heart sounds on paper. It gives an accurate definition of whether there are disturbances in them, noises. Clarifies those tones that can not be heard with a stethoscope.
- Electrocardiography - provides information on whether there is an increase in the heart chambers, whether there is an overload in their work, reveals a change in conductivity.
- Aortography - examination of the structure of the aorta. It introduces a special contrast agent, which stands for itself in the X-ray study of the main line. Informative method.
- Radiography - Chest examination is performed. Often the procedure is supplemented with the use of contrast medium, which makes it possible to see a lung pattern, details of abnormalities in the operation of the ventricles. This method is necessarily used to diagnose this defect.
- Catheterization - in the heart area with the help of a catheter is introduced equipment that transmits complete information about the structure and anomalies of internal structures.
- Echocardiography is a safe method, it provides valuable information on the structure of the main vessels and the septum between the ventricles.
- Analyzes - blood and urine tests will help to understand the general condition of the body and determine whether there are any other pathologies.
Treatment of
The main method of helping patients with a common arterial trunk is surgery. All other procedures are aimed at maintaining a normal state before or after surgery.
Therapeutic and medication-based
Patients who are diagnosed with the common trunk pathology should follow the recommendations of specialists to avoid inflammation of the heart membranes.
Diuretics and glycosides are used before surgery. They alleviate the condition of newborns with symptoms of heart failure. This can only be a temporary measure.
Next, we'll talk about whether the newborn is operable with a common arterial trunk.
Operation
Narrowing the branches that extend from the pulmonary artery, improve the overall picture of the disease, and allow for a time to postpone a radical intervention. Therefore, there is a palliative operation that solves the problem of ligation of the pulmonary arteries.
The main method of troubleshooting is an open operation. Intervention is necessary to correct the congenital anomalies by dividing the common trunk into two mains. The defect of the septum, which almost always accompanies this type of vice, is also reconstructed.
To perform the task, prostheses are often used. When the child grows up, it is necessary to replace the existing prosthesis with a larger device.
Modern medicine has learned to do corrective operations without prior palliative intervention. But this is if the patient's condition allows.
There are cases when a child can not be operated. This applies to patients who have increased resistance to lung vessels. They are born with a more pronounced cyanosis. Help such children will be possible after a while, making a transplantation of the lungs and the heart.
The following video will show an example of the operation of correction of the common arterial trunk:
Prevention of the disease
During the gestation of the child, the woman should protect herself as much as possible from negative factors:
- should not be in the zone of unfavorable ecology,
- should not be exposed to harmful chemicals,
- gently take medicines, consult a doctor;
- refuse to take alcohol and exclude from their habits smoking,
- not to expose itself to ionizing radiation,
- is observed in specialists, so that if the fetus has a common arterial trunk, gain time to help him through an early diagnosis.
Complications of
It is important to determine the disease as early as possible in order to have time to prepare a patient for surgical intervention and to conduct it. Increased pressure in the right ventricle is not characteristic of him. It arises due to the fact that there is a message between the arterial and venous blood, and the pressure in the ventricles is equalized.
Increased pressure in the lung vessels causes a resistance reaction that initiates the hypertension of the lungs. This is an irreversible process in which a corrective operation is not performed. The situation is life-threatening, only a lung and heart transplant can help.
Forecast
If a corrective operation is performed in time, then the forecast is usually positive. It should be observed for a long time from a specialist and with age to replace stitches in early childhood prostheses.
Special case: general arterial trunk and right ventricular hypoplasia
Congenital malformations can also occur in combination with each other. So, if the described pathology is also loaded with a reduced size of the right ventricle, then the tension in it can be unnaturally high.
The defect in the septum and the common trunk makes it possible to discharge venous blood and somewhat reduce the stress on the right side. The transfer of venous blood increases cyanosis. An urgent operation is required, so that irreversible phenomena do not occur.