Truncus arteriosus is a congenital heart malformation where systemic, pulmonary and coronary circulation is supplied by a single artery arising from the heart. Surgical correction of this disorder remains the treatment of choice. Presenting the case of a 21-year-old male, who underwent surgical correction of the anomaly in youth, we review management and follow-up strategy for adult patients after correction of truncus arteriosus. Conduit failure is the most commonly observed long-term consequence of the surgical correction. We evaluate diagnostic algorithm and indications for conduit replacement. JRCD 2014; 1 (8): 15–18