COMMON ARTERIAL TRUNK, UNCOMMON CORONARY ARTERIAL ANATOMY

Macroscopic investigation was done in 44 postmortem specimens of heart s with common arterial trunk. In 38 hearts, the normal distribution in left and right coronary arteries was found. Of the coronary orifices, five were pinpoint and three showed a double orifice. The left corona ry orifice was positioned in the posterior part of the truncus (p < 0. 0001); the right coronary orifice was positioned in the right anterior and lateral part (p < 0.0001). In 19 hearts, coronary orifices were f ound above sinus level, left coronary orifices more often than right c oronary orifices (p < 0.001). In seven hearts, type I truncus was foun d, in seven type II truncus was found, in 17 the truncus was intermedi ate between types I and II, in two type III truncus was found. In 11 h earts, the pulmonary artery distribution could no longer be identified . The truncal valve was bicuspid in 11 hearts, tricuspid in 25 hearts, and quadricuspid in eight hearts. The truncal valve showed overriding of 5 % to 100 %. Malformations of the coronary arteries were found in 28 hearts (64 %). In 27 hearts (61 %), the coronary arterial anatomy might have had clinical consequences. In nine hearts, coronary arteria l orifices were at risk in excision of the pulmonary arteries from the common arterial trunk. The role of the neural crest as an etiologic f actor of coronary arterial malformations in common arterial trunk shou ld be taken into account.