Atrial isomerism: a surgical experience
Section snippets
Methods
Surgery reports and protocols from January 1980 to December 1996 were reviewed for records of atrial isomerism. Diagnosis was based on the morphology of the atrial appendages for patients undergoing open-heart surgery, and on chest radiography and identification of lung and bronchial anatomy at thoracotomy for those undergoing extracardiac palliative procedures. The cases were then studied for associated vascular and cardiac anomalies, type of operation and postoperative results. The current
Patients and results
Forty-one children among 2696 open-heart surgery and 1358 thoracotomy cases (41/4054=1.0%) were described as having left atrial isomerism in 23 and right atrial isomerism in 18.
Discussion
In the large autopsy study from Children's Hospital of Pittsburgh [3], atrial isomerism was found in 3.1% (58/1842) of cases. Right atrial isomerism was more frequently seen (1.9%: 36/1842) than the left isomerism (1.2%: 22/1842). Atrial isomerism incidence was 1.5% (2/132) at transoesophageal echocardiography in patients prospectively evaluated for congenital cardiac lesions by Stümper et al. [8]. The lower incidence of atrial isomerism and the relative higher incidence of left atrial
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