Truncus arteriosus (TA) is a rare cyanotic congenital cardiac lesion where survival past the neonatal period is unexpected, with 90% mortality in infancy and rare cases reaching adulthood. This case series of three adult Afro-Caribbeans, of high intellect, and TA as their sole physical anomaly, who have had no intervention, focusses on the innate structural echocardiographic findings that facilitate longevity and can be a guide in the refinement of the development of the early intervention and surgical management of TA. This case series includes: previously published, the longest survivor Type 3 TA with balanced ventricles, now a 48 years old male still living and two Index cases of Type 1 TA in two 18-year-olds, where TA are their sole physical deformity.
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