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. 1981 Mar;45(3):236–247. doi: 10.1136/hrt.45.3.236

Analysis of atrioventricular junction, ventricular mass, and ventriculoarterial junction in 43 specimens with atrial isomerism.

S De Tommasi, L Daliento, S Y Ho, F J Macartney, R H Anderson
PMCID: PMC482520  PMID: 7470338

Abstract

We have analysed the atrioventricular junction, ventricular mass, and ventriculoarterial junction in 43 hearts with isomeric atrial chambers. Of the hearts, 32 had atrial chambers of bilateral right morphology while 11 had atrial chambers with bilateral left atrial characteristics. Among the hearts with right atrial isomerism, there were 13 biventricular hearts, all with ambiguous atrioventricular connection. Eight had a common valve and five had two atrioventricular valves. In the other 19 hearts, the atrial chambers were connected to only one ventricular chamber, 18 having double inlet ventricle through a common valve and the other having absence of the left atrioventricular connection. In these univentricular hearts, all possible types of ventricular morphology were found. The ventriculoarterial junction among these hearts with right isomerism showed great variation. In the hearts with left atrial isomerism, nine hearts had two ventricles and two were univentricular. The biventricular hearts all had ambiguous atrioventricular connection, six via a common valve and three via two valves. The two univentricular hearts both had double inlet via a common valve, one to a chamber of right ventricular type and the other to a chamber of left ventricular type. Both had rudimentary chambers of complementary pattern. The ventriculoarterial junction again showed much variation. Statistical analysis showed that pulmonary obstruction and a univentricular heart were both significantly more frequent in association with right compared with left isomerism. Significant differences were also noted in the two groups in terms of ventriculoarterial connections and infundibular morphology.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson R. H., Shinebourne E. A., Gerlis L. M. Criss-cross atrioventricular relationships producing paradoxical atrioventricular concordance or discordance. Their significance to nomenclature of congenital heart disease. Circulation. 1974 Jul;50(1):176–180. doi: 10.1161/01.cir.50.1.176. [DOI] [PubMed] [Google Scholar]
  2. Ando F., Shirotani H., Kawai J., Kanzaki Y., Setsuie N. Successful total repair of complicated cardiac anomalies with asplenia syndrome. J Thorac Cardiovasc Surg. 1976 Jul;72(1):33–38. [PubMed] [Google Scholar]
  3. Bharati S., Lev M. Positional variations of the heart and its component chambers. Circulation. 1979 May;59(5):886–887. doi: 10.1161/01.cir.59.5.886. [DOI] [PubMed] [Google Scholar]
  4. Caruso G., Becker A. E. How to determine atrial situs? Considerations initiated by 3 cases of absent spleen with a discordant anatomy between bronchi and atria. Br Heart J. 1979 May;41(5):559–567. doi: 10.1136/hrt.41.5.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dickinson D. F., Wilkinson J. L., Anderson K. R., Smith A., Ho S. Y., Anderson R. H. The cardiac conduction system in situs ambiguus. Circulation. 1979 May;59(5):879–885. doi: 10.1161/01.cir.59.5.879. [DOI] [PubMed] [Google Scholar]
  6. IVEMARK B. I. Implications of agenesis of the spleen on the pathogenesis of conotruncus anomalies in childhood; an analysis of the heart malformations in the splenic agenesis syndrome, with fourteen new cases. Acta Paediatr Suppl. 1955 Nov;44(Suppl 104):7–110. [PubMed] [Google Scholar]
  7. Macartney F. J., Zuberbuhler J. R., Anderson R. H. Morphological considerations pertaining to recognition of atrial isomerism. Consequences for sequential chamber localisation. Br Heart J. 1980 Dec;44(6):657–667. doi: 10.1136/hrt.44.6.657. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Moller J. H., Nakib A., Anderson R. C., Edwards J. E. Congenital cardiac disease associated with polysplenia. A developmental complex of bilateral "left-sidedness". Circulation. 1967 Nov;36(5):789–799. doi: 10.1161/01.cir.36.5.789. [DOI] [PubMed] [Google Scholar]
  9. Partridge J. B., Scott O., Deverall P. B., Macartney F. J. Visualization and measurement of the main bronchi by tomography as an objective indicator of thoracic situs in congenital heart disease. Circulation. 1975 Jan;51(1):188–196. doi: 10.1161/01.cir.51.1.188. [DOI] [PubMed] [Google Scholar]
  10. Rose V., Izukawa T., Moës C. A. Syndromes of asplenia and polysplenia. A review of cardiac and non-cardiac malformations in 60 cases withspecial reference to diagnosis and prognosis. Br Heart J. 1975 Aug;37(8):840–852. doi: 10.1136/hrt.37.8.840. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Shinebourne E. A., Macartney F. J., Anderson R. H. Sequential chamber localization--logical approach to diagnosis in congenital heart disease. Br Heart J. 1976 Apr;38(4):327–340. doi: 10.1136/hrt.38.4.327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Soto B., Becker A. E., Moulaert A. J., Lie J. T., Anderson R. H. Classification of ventricular septal defects. Br Heart J. 1980 Mar;43(3):332–343. doi: 10.1136/hrt.43.3.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Soto B., Pacifico A. D., Souza A. S., Jr, Bargeron L. M., Jr, Ermocilla R., Tonkin I. L. Identification of thoracic isomerism from the plain chest radiograph. AJR Am J Roentgenol. 1978 Dec;131(6):995–1002. doi: 10.2214/ajr.131.6.995. [DOI] [PubMed] [Google Scholar]
  14. Stanger P., Rudolph A. M., Edwards J. E. Cardiac malpositions. An overview based on study of sixty-five necropsy specimens. Circulation. 1977 Aug;56(2):159–172. doi: 10.1161/01.cir.56.2.159. [DOI] [PubMed] [Google Scholar]
  15. Tynan M. J., Becker A. E., Macartney F. J., Jiménez M. Q., Shinebourne E. A., Anderson R. H. Nomenclature and classification of congenital heart disease. Br Heart J. 1979 May;41(5):544–553. doi: 10.1136/hrt.41.5.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. VAN MIEROP L. H., WIGLESWORTH F. W. Isomerism of the cardiac atria in the asplenia syndrome. Lab Invest. 1962 Dec;11:1303–1315. [PubMed] [Google Scholar]
  17. Van Mierop L. H., Eisen S., Schiebler G. L. The radiographic appearance of the tracheobronchial tree as an indicator of visceral situs. Am J Cardiol. 1970 Oct;26(4):432–435. doi: 10.1016/0002-9149(70)90743-5. [DOI] [PubMed] [Google Scholar]

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