Dextrocardia: Angiocardiographic study and classification

Abstract

The angiocardiographic features in 65 cases of dextrocardia studied at the Mayo Clinic between December 1960 and November 1970 have been reviewed. In 60 cases the angiocardiographic studies were adequate to define the situs of the atria, the ventricular morphology, and the relation of the great arteries. The heart and great vessels were examined at complete surgical repair in 23 cases and at autopsy in 13. From review of the angiocardiographic data and comparison with the surgical and autopsy findings, an angiocardiographic classification of dextrocardia is proposed. Situs solitus of viscera and atria was present in 44 cases—23 with inverted ventricles, 14 with noninverted ventricles and 7 with common ventricle. Levotransposition of the great arteries was seen in 24, dextrotransposition in 7, zero-transposition (aorta directly anterior to pulmonary artery) in 5, and normal relation of the great arteries in 8. Situs inversus of viscera and atria occurred in 11 cases: 8 with noninverted and 3 with inverted ventricles. Inverted normally related great arteries were present in five cases, inverted dextrotransposition in one, inverted levotransposition in two, zero-transposition in two, and normally related great arteries (isolated inversion of the ventricles) in one. In five cases of dextrocardia, the situs of the viscera was indeterminate. Diagnostic accuracy and a better understanding of the various types of dextrocardia are essential, since improved surgical techniques have made it possible to correct many of these complex abnormalities.