All issues > Volume 29(2); 1986

Original Article

J Korean Pediatr Soc. 1986;29(2):186-202. Published online February 28, 1986.

Cardiac Malposition.

Sejung Sohn¹, Jung Yun Choi¹, Yong Soo Yun¹, Chang Yee Hong¹, Je G Chi²

¹Department of Pediatrics, College of Medicine, Seoul National University
²Department of Pathology, College of Medicine, Seoul National University

Abstract

Cardiac malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Authors analyzed the clinical, radiological, operative and autopsy findings of 69 patients with cardiac malpositions by segmental approach to describe the internal cardiac anatomy and their arterial connections. 1) Male to female sex ratio was 1.23 : 1 and 68% of cases were under 5 years of age at the first visit. 2) Among 69 cases of cardiac malpositions, 50 cases were dextrocardia, 18 cases were isolated levocardia and 1 case was mesocardia. 3) Among 50 cases of dextrocardia, 18 cases were dextrocardia in situs solitus, 28 cases were dextrocardia in situs inversus and 4 cases were dextrocardia in situs ambiguus with asplenia. And anatomic types of dextrocardia were analyzed. 4) Among 18 cases of isolated levocardia, 11 cases were levocardia in situs inversus and 7 cases were levocardia in situs ambiguus. Among these 7 cases, 2 cases occurred with asplenia and 5 cases occured with polysplenia. 5) Segmental analysis revealed 7 different types in dextrocardia in situs solitus, 10 types in dextrocardia in situs inversus and 6 types in levocardia in situs inversus. 6) There were 2 cases of visceroatrial discordance. 7) Associated cardiac malformations were varible and complex with a tendency of high association of corrected transposition of great arteries in dextrocardia in situs solitus and single ventricle in dextrocardia in situs inversus and levocardia. 8) There were 6 cases of asplenia, 5 cases of polysplenia, 1 case of accessory spleen, 2cases of pigeon chest, 2 cases of intestinal malrotation, 1 case of funnel chest, 1 case of hydrocele and 1 case of spina bifida as extracardiac anomalies. 9) Associated diseases were bronchiectasis in 1 case, chronic renal failure in 1 case and sinusitis in 1 case. 10) There was no case with exception of loop rule 1 case.

Keywords :Cardiac malposition; Dextrocardia; Levocardia; Mesocardia.