Introduction: Single ventricle and truncus arteriosus are both rare congenital cardiac syndromes with limited survival. Their occurrence together is extremely uncommon and prolonged survival is exceptionally rare. We present the case of a patient who had both of these defects with survival to age 45.

Case presentation: We describe the vase of a 45-year-old man with the unusual occurrence of two very rare congenital cardiac defects. He was found to have both truncus arteriosus and single ventricle with long survival. His history, clinical course, and anatomic findings are discussed along with the factors which may have contributed to his longevity, which is unique in the medical literature. His management reflected the state of medical knowledge at the time when he presented, and although alternate approaches may have been utilized if the patient presented today, this case does indicate the efficacy of the management options available at the time and place of the patient's contacts with the medical care system in Belarus. We discuss the findings, frequency, classification, and management of both of these congenital defects.

Conclusion: This case demonstrates that patients with very complex congenital cardiac disease may survive to adulthood, presenting challenges in both medical and surgical treatment. As the management of these patients is constantly evolving, and interventional techniques are improving, patients such as this with prolonged survival will be more common, with each case providing insights to future treatment. Challenges in management may include prior care provided in health care systems with limited resources.