<prompt> Persistent truncus aeriosus leads to:Bilateral ventricular hyperophyPulmonary oligemiaDuctus dependent flowCCF at bih  <response>: TRUNCUS AERIOSUS: - Single aerial trunk arises from hea supplies - systemic, pulmonary coronary circulations. VSD is always present with it. - Associated with DiGeorge syndrome - deletion of large region of 22q11 - Clinical features: Immediate new born period - Hea failure is absent. Murmur minimal cyanosis are only initial findings Next 1-2 months of life - Hea failure is seen dt increased pulmonary circulation; but still minimum cyanosis is present Wide pulse pressure bounding pulses are seen Systolic ejection murmur sometimes accompanied by thrill - audible along left sternal border - Diagnosis: ECG - shows right, left combined ventricular hyperophy X-ray - Cardiac enlargement in 1st week of life - Increased pulmonary vascularity after 1st few weeks of life - pulmonary plethora Echocardiography: Diagnostic demonstrate large truncal aery overriding VSD pattern of origin of pulmonary aeries. - It is Ductus independent. 