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Abstract
RÉSUMÉ
Introduction. Le tronc artériel commun est une cardiopathie congénitale dans laquelle un tronc artériel unique émerge de la base du cœur au-dessus d’une valve semi-lunaire unique, appelée valve troncale. Notre travail avait pour objectif de décrire les aspects cliniques, échographiques et thérapeutiques du tronc artériel commun chez 8 enfants guinéens. Méthodologie. Nous avons réalisé une étude rétrospective, longitudinale des dossiers de huit patients admis dans le service de cardiologie sur une période de 13 mois allant de Décembre 2021 à Janvier 2023. Les paramètres étudiés étaient cliniques, échographiques et thérapeutiques. Résultats. Sur une période de 8 mois, nous avons colligé 8 cas de TAC. Il y avait 6 filles et 2 garçons. L’âge moyen au moment du diagnostic était de 4 semaines. Les signes révélateurs étaient ceux du shunt gauche droit. A l’échographie cardiaque le type 2 de Van Praagh est présent dans six cas sur huit. Seuls, quatre enfants ont été opérés. Trois sont décédés avant l’opération. Conclusion. La présentation clinique du TAC chez l’enfant guinéen est classique avec un taux de létalité pré chirurgical très élevé (39%). Le type 2 de Van Praagh est rencontré dans 75% des cas.
ABSTRACT
Introduction. Truncus arteriosus (TC) is a congenital heart disease in which a single truncus arteriosus emerges from the base of the heart above a single semilunar valve, called the truncal valve. The aim of our work was to describe the clinical presentation, the echocardiographic findings and the management of common truncus arteriosus of three Guinean children. Methodology. We conducted a retrospective, longitudinal study of the records of 8 patients admitted to the cardiology department over a 13-month period from December 2021 to January 2023. The parameters studied were clinical, echographic and therapeutic. Results. Over a period of 8 months, we collected 8 cases of TAC. The female sex was the most frequent in our study, with 6 girls and 2 boys. The symptoms were early with an average of 4 weeks. The revealing signs were those of a left-right shunt. On cardiac ultrasound, Van Praagh type 2 was the most common (6 cases). Four children underwent surgery. Three died. Conclusion. The clinical presentation of TC of Guinean Children is essentially similar to what has been described elsewhere. 39% of children die before operation. The most common anatomical type is Type 2 of Van Praagh.
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References
- Bassil-Eter R, Acar P, Léobon B. Tronc artériel commun. EMC (Elsevier Masson SAS, Paris). 2007 ; 11 : 940-950.
- Wen R, Oui Jim L , Kenneth Wei QG et al. Surgical correction of persistent truncus arteriosus on a 33-year-old male with unilateral pulmonary hypertension from migration of pulmonary artery band. J Cardiothorac Surg. 2016; 11: 39. doi: 10.1186/s13019-016-0435-x.
- O'Byrne M L, Mercer-Rosa L, Zhao H et al. Morbidity in children and adolescents after surgical correction of truncus arteriosus communis. Am Heart J. 2013 sept ; 166 (3): 512–518. doi: 10.1016/j.ahj.2013.05.023
- Poaty H , Pelluard F , André G. Truncus arteriosus communis: report of three cases and review of literature. Afr Health Sci. 2018 mars ; 18(1): 147–156. doi: 10.4314/ahs.v18i1.19
- Gouton M, Lucet V, Bical O, Leca F. Late management of truncus arteriosus: 20 years of humanitarian experience. Cardiology in the Young (2018), 28, 302–308.
- Kamdem F, Noukeu D, Jingi AM, et al. Profil Échocardiographique des Cardiopathies Congénitales chez les Nouveau- Nés et les Nourrissons à Douala. Health Sci. Dis: Vol 21 (2) February 2020 :33-38
- Ndongo-Amougou S, Jingi AM, Otseng Abe A et al. Aspects Épidémiologiques, Cliniques et Thérapeutiques des Cardiopathies Congénitales dans Deux Hôpitaux de Yaoundé. Health Sci. Dis: Vol 23 (1) January 2022 : 52-55
- Digilio MC , Marino B , Musolino AM , Giannotti A , Dallapiccola B . Familial Recurrence of Nonsyndromic Interrupted Aortic Arch and Truncus Arteriosus With Atrioventricular Canal. Teratology 61:329–331 (2000) .
- Gotsch F, Romero R, Espinosa J et al. Prenatal diagnosis of truncus arteriosus using multiplanar display in 4D ultrasonography. J Matern Fetal Neonatal Med. 2010 April ; 23(4): 297–307. doi:10.3109/14767050903108206.
- Ta-Shma A, El-lahham N, Edvardson S, et al. Conotruncal malformations and absent thymus due to a deleterious NKX2-6 mutation. J Med Genet. 2014 Apr;51(4):268-70. doi: 10.1136/jmedgenet-2013-102100
- Stavsky M, Robinson R, Sade MY, et al. Elevated birth prevalence of conotruncal heart defects in a population with high consanguinity rate. Cardiology in the Young 2017 ; 27 (1):109–116.
- Van Praagh R, Van Praagh S. The anatomy of common aorticopulmonary trunk (truncus arteriosus communis) and its embryologic implications: a study of 57 necropsy cases. Am J Cardiol 1965;16:406-425
- Abel S , Berg C , Geipel A et al. Prenatal diagnosis, associated findings and postnatal outcome of fetuses with truncus arteriosus communis (TAC). Arch Gynécol Obstet. 2021 ;304(6) : 1455-1466. doi: 10.1007/s00404-021-06067-x
- Miyamoto T, Sinzobahamvya N, Kumpikaite D, Asfour B, Photiadis J, Brecher AM, Urban AE. Survival after Surgery with Cardiopulmonary Bypass in Low Weight Patients. Ann ThoracSurg. 2005 ;79 :2077–2082.
- Marcelletti C, McGoon DC, Mair DD. The natural history of truncus arteriosus. Circulation 1976 ; 54:108-111.
References
Bassil-Eter R, Acar P, Léobon B. Tronc artériel commun. EMC (Elsevier Masson SAS, Paris). 2007 ; 11 : 940-950.
Wen R, Oui Jim L , Kenneth Wei QG et al. Surgical correction of persistent truncus arteriosus on a 33-year-old male with unilateral pulmonary hypertension from migration of pulmonary artery band. J Cardiothorac Surg. 2016; 11: 39. doi: 10.1186/s13019-016-0435-x.
O'Byrne M L, Mercer-Rosa L, Zhao H et al. Morbidity in children and adolescents after surgical correction of truncus arteriosus communis. Am Heart J. 2013 sept ; 166 (3): 512–518. doi: 10.1016/j.ahj.2013.05.023
Poaty H , Pelluard F , André G. Truncus arteriosus communis: report of three cases and review of literature. Afr Health Sci. 2018 mars ; 18(1): 147–156. doi: 10.4314/ahs.v18i1.19
Gouton M, Lucet V, Bical O, Leca F. Late management of truncus arteriosus: 20 years of humanitarian experience. Cardiology in the Young (2018), 28, 302–308.
Kamdem F, Noukeu D, Jingi AM, et al. Profil Échocardiographique des Cardiopathies Congénitales chez les Nouveau- Nés et les Nourrissons à Douala. Health Sci. Dis: Vol 21 (2) February 2020 :33-38
Ndongo-Amougou S, Jingi AM, Otseng Abe A et al. Aspects Épidémiologiques, Cliniques et Thérapeutiques des Cardiopathies Congénitales dans Deux Hôpitaux de Yaoundé. Health Sci. Dis: Vol 23 (1) January 2022 : 52-55
Digilio MC , Marino B , Musolino AM , Giannotti A , Dallapiccola B . Familial Recurrence of Nonsyndromic Interrupted Aortic Arch and Truncus Arteriosus With Atrioventricular Canal. Teratology 61:329–331 (2000) .
Gotsch F, Romero R, Espinosa J et al. Prenatal diagnosis of truncus arteriosus using multiplanar display in 4D ultrasonography. J Matern Fetal Neonatal Med. 2010 April ; 23(4): 297–307. doi:10.3109/14767050903108206.
Ta-Shma A, El-lahham N, Edvardson S, et al. Conotruncal malformations and absent thymus due to a deleterious NKX2-6 mutation. J Med Genet. 2014 Apr;51(4):268-70. doi: 10.1136/jmedgenet-2013-102100
Stavsky M, Robinson R, Sade MY, et al. Elevated birth prevalence of conotruncal heart defects in a population with high consanguinity rate. Cardiology in the Young 2017 ; 27 (1):109–116.
Van Praagh R, Van Praagh S. The anatomy of common aorticopulmonary trunk (truncus arteriosus communis) and its embryologic implications: a study of 57 necropsy cases. Am J Cardiol 1965;16:406-425
Abel S , Berg C , Geipel A et al. Prenatal diagnosis, associated findings and postnatal outcome of fetuses with truncus arteriosus communis (TAC). Arch Gynécol Obstet. 2021 ;304(6) : 1455-1466. doi: 10.1007/s00404-021-06067-x
Miyamoto T, Sinzobahamvya N, Kumpikaite D, Asfour B, Photiadis J, Brecher AM, Urban AE. Survival after Surgery with Cardiopulmonary Bypass in Low Weight Patients. Ann ThoracSurg. 2005 ;79 :2077–2082.
Marcelletti C, McGoon DC, Mair DD. The natural history of truncus arteriosus. Circulation 1976 ; 54:108-111.