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In our series, 2 of the 4 patients were diagnosed as having right isomerism associated with complex cardiac anomalies.
Often, dextrocardia, complete atrioventricular septal defect, and transposed great arteries occur in both right atrial and left atrial isomerism.
It is more accurate, therefore, to speak of isomerism of the appendages.
It is the pulmonary veins, however, which most accurately reflect the presence of isomerism, and serve as discriminant markers of the right and left patterns.
Morphological considerations pertaining to recognition of atrial isomerism.
In left isomerism, the venous sinus fails to incorporate into the right-sided atrium.
Other persons may have discordance between the thoracic organs, which are usually arranged, and the abdominal organs, which are mirror-imaged, but no evidence of isomerism.
These are 'right (or left) ventricular isomerism' and 'ambiguous ventriculoarterial connections'.
Patients with atrial isomerism and hypoplastic left heart syndrome were excluded from the study.
Fetal echocardiography establishes abnormal intracardiac relationships and reveals whether heterotaxy is present and whether there is right or left isomerism.
Over the same period, 50 patients with right isomerism were seen in our hospital and formed a contrasting group.
The morphological condition of ventricular isomerism, therefore, is exceedingly rare.
We report four cases showing this combination of findings, three having usual atrial arrangement and the remaining one showing isomerism of the left atrial appendages.
Isomerism of the atrial appendages-goodbye to asplenia and all that.
We have not, as yet, come across a case of left ventricular isomerism.
