Isolated levocardia: Prenatal diagnosis and management

Abstract

Isolated levocardia (IL) is a rare condition of situs anomaly in which there is a normal left-sided heart (levocardia) with dextro position of the abdominal viscera. IL has been reported in children and adults with complex cardiac defects, whereas there are only few published reports regarding the prenatal diagnosis of IL. We report two prenatal cases of IL diagnosed by ultrasonography and magnetic resonance imaging (MRI). In both cases, fetal cardiac function remained within the normal range throughout pregnancy, and no treatment for the heart was required after birth. For the dextro position of abdominal viscera, one case was followed without any surgical procedure, but the other case required prophylactic operation due to malrotation of the small intestine. Although the prognosis of IL largely depends on the severity of associated cardiac anomaly, future bowel obstruction caused by intestinal malrotation may also be life-threatening. In this respect, prenatal diagnosis of IL is important, even when there is no associated cardiac structural anomaly. If IL is suspected in routine fetal ultrasonography, MRI may be recommended to obtain more detailed information on the anatomy of abdominal viscerae, and careful observation for bowel problems is required, especially after oral nutrition is started.

Determining bronchial morphology for the purposes of segregating so-called heterotaxy

“…The patients had normally structured hearts, without any caval venous abnormalities. [28][29][30][31][32][33] The possibility that some might have had isomeric left appendages, however, cannot be discounted, as others have noted conduction abnormalities in these settings, such as sick sinus syndrome, or disordered atrioventricular nodal conduction. 34,35 Our study has its obvious limitations.…”

Rare case of isolated levocardia with polysplenia including normally structured lung without cardiac anomaly

“…There are only a few published reports regarding the prenatal diagnosis of IL (Gindes et al . 2007; Katsuya et al . 2009).…”

“…There are only a few published reports regarding the prenatal diagnosis of IL (Gindes et al 2007;Katsuya et al 2009). Owing to the progress in fetal imaging techniques, similar cases of IL diag-nosed before birth will be increasingly reported.…”

The developing role of fetal magnetic resonance imaging in the diagnosis of congenital cardiac anomalies: A systematic review

“…Fetal MRI has been used to diagnose various forms of CCA such as cardiac rhabdomyoma,[2] truncus arteriosus,[3] isolated levocardia,[4] and others. [5–9] A retrospective study recently defined fetal MRI findings to detect twin reversed arterial perfusion sequence in monochorionic pregnancies.…”