A single trunk, with just one group of semilunar valves, arises from the base of the heart. All coronary arteries and the pulmonary artery originate from the trunk. This semilunar organ can be separated into three leaflets (Fig. 20.2f) (similar to normal AVs) or into two or four leaflets, which is the common arterial trunk, also known as persistent truncus arteriosus. A VSD is usually associated with this disorder (Fig. 20.2e).

In this condition, the embryological structure known as the truncus arteriosus fails to divide properly into the pulmonary trunk and aorta, resulting in a series of anatomical changes, including VSD and semilunar dysplasia. This great vessel usually has one large valve that usually has three leaflets. The aortic trunk customarily sits over both ventricles, but occasionally it can originate from only one of them. The upper portion of the wall between these two chambers is missing, resulting in what is known as a subarterial ventricular septal defect. If the artery cone remains its proximal residue, then the VSD is known as an intracristal type. In this condition, the heart conduction bundle is a far distance from the border of the septum defect.

Four anatomical types of truncus arteriosus (Fig. 20.1) are recognized on the basis of the anatomical origin of the pulmonary arteries:

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