Association of Cardiac Anomalies in Pediatric Dextrocardia: A CT Angiographic Study

Abstract

Background: Dextrocardia is an intrinsic cardiac malposition where the base-apex axis is oriented toward the right side. Diagnosing these abnormalities is crucial for the appropriate treatment of associated anomalies. Advances in CT angiography techniques have enabled a comprehensive study of cardiovascular structures. Objectives: This study aims to identify the association of cardiac anomalies in various types of dextrocardia. Methods: Patients with a confirmed diagnosis of dextrocardia who underwent contrast-enhanced cardiac CT angiography were included in the study. All patients had previously undergone echocardiography with equivocal findings. The type of dextrocardia (based on the Arcilla and Gasul classification), along with septal, atrial, ventricular, aortic, pulmonary artery and vein, systemic veins, and non-cardiac anomalies, were evaluated. Results: Thirty-five cases of dextrocardia (18 males and 17 females) were included in this study, with a mean patient age of 24 months. Among these, 23 cases were classified as type 3, 8 as type 1, and 4 as type 2. The most common anomalies across all types were septal defects, with ventricular septal defects being the most prevalent in type 1, while atrioventricular septal defects (AVSD) were the most common in types 2 and 3. In type 3, left transposition of the great arteries (L-TGA), right isomerism, and AVSD were significantly more frequent, occurring concurrently in 65.2% of patients. Additionally, more than 50% of the cases had a concomitant pulmonary artery anomaly. Conclusions: A correlation may exist between the occurrence of AVSD, L-TGA, right isomerism, and pulmonary artery anomalies in type 3 dextrocardia.