Severe pulmonary hypertension associated with common arterial trunk in a 9- year- old child
Caspian J Intern Med. 2020 Fall;11(4):454-457. doi: 10.22088/cjim.11.4.454.
BACKGROUND: Common arterial trunk (CAT) is a rare congenital heart disease, and often leads to the early development of pulmonary hypertension and disability. Among the critical structural heart defects, the frequency of CAT is 3%, which reflects the severe hemodynamic disturbances. The natural course of the disease is characterized by a high mortality rate up to 88% during the first year of life. We introduce a patient with common arterial trunk disease.
CASE PRESENTATION: The article describes a case of a 9-year old boy with a diagnosis of type I common arterial trunk (CAT) that rejected recommendations of many physicians for many years. At 7 months, the baby was diagnosed as CHD and at 3 years, a cardiac catheterization was performed and the final diagnosis was common arterial trunk, type I with defect of interventricular septum and pulmonary hypertension. However, at that time, parents refused the operation. The health status of the last examination was bad due to high pulmonary hypertension and chronic arterial hypoxemia. Drug therapy continued with bosentan, sildenafil, captopril, kudesang, spironolactone and aspirin.
CONCLUSION: The late detection of children with CAT or late surgery leads to the rapid progression of pulmonary hypertension and significantly reduces the patient’s chances for performing surgical correction of the defect.