The two Great Arteries (Aorta and Pulmonary Artery) have a single origin from the heart and blood from both ventricles passes across a VSD into the single arterial trunk. The lung circulation is exposed to very high pressure and increased blood flow (as with a large VSD). Heart failure often develops in the early weeks of life.

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Complete repair for Truncus necessitates the insertion of a 'Conduit', which is a tube containing a valve placed to connect the right ventricle to the pulmonary artery. The VSD is also closed with a patch. Operation needs to be performed in the first six months of life.