Presentación clínica y evolución del isomerismo derecho

Lafuente, María V.; Villalba, Claudia; Mouratian, Mariela; Villa, Alejandra; Sciegata, Alberto; Delucis, Pablo García; Capelli, Horacio

doi:10.7775/rac.es.v83.i5.5434

Cited by 4 publications

(3 citation statements)

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“…We found a predominance of RAI opposed to LAI, as reported in the literature, 13,14,16,[20][21][22][23][24][25] with a prevalence at our institution of 58.5% versus 41.5%, respectively. We agree with be appropriately diagnosed and classified in the preoperative setting with help from the auxiliary diagnostic team at our institution.…”

Section: Resultssupporting

confidence: 83%

“…We found a predominance of RAI opposed to LAI, as reported in the literature, 13,14,16,20–25 with a prevalence at our institution of 58.5% versus 41.5%, respectively. We agree with Alongi et al and Baban et al, about the challenge it poses to make a precise diagnosis in both cases, even with the direct visualization of the atrial morphology during the surgical event; 13,20 however, in our experience, all cases were able to be appropriately diagnosed and classified in the preoperative setting with help from the auxiliary diagnostic team at our institution.…”

Section: Discussionsupporting

confidence: 81%

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Cardiac surgery in patients with atrial isomerism: Long‐term results and outcomes

Ortega-Zhindón

Calderón‐Colmenero

García-Montes

et al. 2021

Journal of Cardiac Surgery

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Purpose: The aim of the study was to identify, determine, and analyze the clinical and surgical outcomes of patients with atrial isomerism (AI) undergoing cardiac surgery.Methods: A retrospective study was carried out. Patients with diagnosis of AI undergoing cardiac surgery at the National Institute of Cardiology Ignacio Chávez, from January 1, 2010 and March 31, 2020 were included; demographic characteristics and perioperative conditions of the patients were considered.Results: Sixty-five patients were included, with an average age of 6.4 ± 4.9 years, 50.8% males. Thirty-eight (58.5%) had right atrial isomerism (RAI) and 27 (41.5%) had left atrial isomerism (LAI); univentricular physiology (78.5%) predominated.Atrioventricular septal defect (AVSD) in RAI and septal defects in LAI were identified as the main associated defects. The most common surgical procedures performed were modified Blalock-Taussig shunt (MBTS) (27.6%), MBTS with total anomalous pulmonary venous connection (TAPVC) repair (15.3%) and total cavopulmonary connection (TCPC) with an extracardiac conduit fenestrated (10.8%); 100% RAI required a univentricular approach, while in LAI it was 48.1%.Overall survival was 92.3%, with 100% survival in LAI with biventricular physiology and 86.8% in RAI with univentricular physiology. Conclusions:The survival of our institution is similar to that of other referral centers, where patients with LAI had a better evolution than RAI; in addition, the univentricular approach was required in all with RAI. Patients with AI must undergo a rigorous evaluation to determine an adequate repair strategy, considering univentricular RAI with a high possibility of morbidity and mortality.

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Section: Resultssupporting

confidence: 83%

Section: Discussionsupporting

confidence: 81%

Cardiac surgery in patients with atrial isomerism: Long‐term results and outcomes

Ortega-Zhindón

Calderón‐Colmenero

García-Montes

et al. 2021

Journal of Cardiac Surgery

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“…Observations in different populations of patients with RAI who underwent univentricular or biventricular repair have been relatively scarce; however, an encouraging picture has emerged in recent years. For instance, the predominant form is RAI [7,22,[25][26][27][28][29][30][31][32], which is found in 58.5% of patients with AI in our center. According to Baban et al [25] and Alongi et al [26], the diagnosis is always a challenge, even when we can directly visualize the atrial morphology during the surgical procedure.…”

Section: Discussionmentioning

confidence: 68%

Cardiac Laterality: Surgical Results of Right Atrial Isomerism

Ortega-Zhindón,

Pérez-Hernández,

Rodríguez-Pérez

et al. 2023

Diseases

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Right atrial isomerism (RAI) is a complex entity with varying diagnostic and treatment outcomes due to its rarity. Treatment options range from palliative to corrective surgeries, resulting in heterogeneous outcomes. The aim of this study was to analyze the results obtained after cardiac surgery in patients with RAI. A retrospective study was conducted, including patients diagnosed with RAI who underwent cardiac surgery. Their follow-up was from 1 January 2010 to 31 March 2020. Demographic characteristics and perioperative conditions were described. Thirty-eight patients were included, the median age was 4 years (IQR 2–9.2) and 57.9% were men. The main diagnoses were atrioventricular canal (63.2%) and pulmonary stenosis (55.3%). The most common surgical procedures were modified Blalock–Taussig shunt (65.8%) and total cavopulmonary connection with an extracardiac conduit fenestrated without cardiopulmonary bypass (15.9%). We did not find any factors associated with negative outcomes in these patients. The overall survival was 86.8%, with a better outcome in those who did not require reintubation (log rank, p < 0.01). The survival of RAI was similar to other centers. Individuals with RAI should be evaluated rigorously to determine an adequate repair strategy, considering high morbidity and mortality.

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Imaging in Heterotaxy Syndromes

Taxak

2023

Case-Based Atlas of Cardiac Imaging

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Presentación clínica y evolución del isomerismo derecho

Cited by 4 publications

References 0 publications

Cardiac surgery in patients with atrial isomerism: Long‐term results and outcomes

Cardiac surgery in patients with atrial isomerism: Long‐term results and outcomes

Cardiac Laterality: Surgical Results of Right Atrial Isomerism

Imaging in Heterotaxy Syndromes

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