Common Arterial Trunk

Common arterial trunk (CAT) is a congenital malformation in which a single arterial trunk arises from the heart, overrides the interventricular septum, and supplies the systemic, pulmonary, and coronary circulations. During embryonic life, the outflow tract of the developing heart, which extends from the distal extent of the developing right ventricle to the margins of the pericardial cavity, possesses a common lumen. Surgical treatment strategies were introduced in the early 1960s and were based on palliative therapy using pulmonary artery banding techniques, with suboptimal results. The overwhelming abnormal pathophysiologic feature of CAT is a large left-to-right shunt that increases after the neonatal period as the pulmonary vascular resistance falls. The operative techniques for repair of CAT have undergone evolutionary advances relating to cannulation and perfusion techniques, myocardial preservation, and types of extracardiac conduits.