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Key anatomical features A single arterial trunk (instead of separate aorta and pulmonary artery) arising from the heart Overriding the ventricular septum, which typically has a large defect (VSD) The truncal valve may be bicuspid, tricuspid, or quadricuspid and often functions abnormally Pulmonary arteries arise directly from the common trunk in various configurations (Van Praagh/Collett-Edwards classification types I-IV) Cyanosis from birth due to mixing of oxygenated and deoxygenated blood The condition requires surgical correction in the neonatal period, typically involving separation of the pulmonary arteries, closure of the VSD, and reconstruction of the right ventricular outflow tract