Isolated ventricular inversion: two-dimensional echocardiographic findings and a review of the literature.

Abstract

In a cyanotic newborn infant, the diagnosis of isolated ventricular inversion in situs solitus was made from the two-dimensional echocardiographic examination and later confirmed at cardiac catheterization and surgery. The four-chamber views were especially useful for identifying the normal atrial situs and discordant atrioventricular connections in this infant. The normal relationships of the great arteries to each other (aortic valve rightward, posterior, and inferior to the pulmonary valve; great arteries coiled around each other) and to the ventricles (mitral-aortic fibrous continuity, well-developed subpulmonic conus) were well defined in the subcostal views. A review of the medical literature revealed a total of 12 cases of isolated ventricular inversion, most of which were diagnosed only at postmortem examination. The two-dimensional echocardiogram provides a rapid, safe technique for prompt diagnosis in these very sick cyanotic infants.