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Isomeric arrangement of the left atrial appendages and visceral heterotaxy: two atypical cases.

Published online by Cambridge University Press:  19 August 2008

L. M. Gerlis*
Affiliation:
Department of Cardiac Morphology, Imperial College School of Medicine at the National Heart and Lung Institute, London, UK
G. Durà-Vilà
Affiliation:
During the course of this study G. D-V. was a visiting medical student from the University of Valencia, Spain
S. Y. Ho
Affiliation:
Department of Cardiac Morphology, Imperial College School of Medicine at the National Heart and Lung Institute, London, UK
*
L.M. Gerlis, National Heart and Lung Institute, Dovehouse Street, London, SW3 6LY. Tel: +44 207 351 8751; Fax: +44 207 351 8230

Abstract

We present two cases in which there was isomeric arrangement oi the left atrial appendages in association with multiple spleens and complete heart block. In both of these, the venous connections were normal. In one case the arrangement of the bronchial tree and the lungs was normal, the liver was left-sided, and the stomach was right-sided. In the other case, there was left isomeric broncho-pulmonary morphology, and both liver and stomach were right-sided. These unusual combinations show the need for full description of the morphology of other organs, and the venoatrial connections, in cases with isomeric arrangement of the atrial appendages. They also demonstrate that connection of the inferior caval vein cannot be taken as a reliable marker of an atrium having a morphologically right appendage.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2000

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References

1.Anderson, C, Devine, WA, Anderson, RH, Debich, D, Zuberbuhler, JR. Abnormalities of the spleen in relation to congenital malformations of the heart: a survey of necropsy findings in children. Br Heart J 1990; 63: 122128.CrossRefGoogle Scholar
2.Anderson, RH, Webb, S, Brown, NA. Defective lateralisation in children with congenitally malformed hearts. Cardiol Young 1998; 8: 512531.CrossRefGoogle ScholarPubMed
3.Jewell, FM, Joffe, HS, Wilde, P. Isomerism of the left atrial appendages with bronchoatrial discordance and unusual systemic venous drainage. Cardiol Young 1993; 3: 225228.CrossRefGoogle Scholar
4.Uemura, H, Ho, SY, Devine, WA, Anderson, RH. Analysis of visceral heterotaxy according to splenic status, appendage morphology, or both. Amer J Cardiol 1995; 76: 846849.CrossRefGoogle ScholarPubMed
5.Caruso, G, Becker, AE. How to determine atrial situs? Considerations initiated by three cases of absent spleen with a discordant anatomy between bronchi and atria. Br Heart J 1979; 41: 559567.CrossRefGoogle Scholar