Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-04-30T12:18:01.958Z Has data issue: false hasContentIssue false

9 - Lesions in Hearts with Abnormal Segmental Connections

Published online by Cambridge University Press:  10 April 2024

Robert H. Anderson ,
Andrew C. Cook ,
Diane E. Spicer ,
Anthony M. Hlavacek ,
Carl L. Backer  and
Justin T. Tretter
Robert H. Anderson
Affiliation:
Institute of Genetic Medicine, Newcastle University
Andrew C. Cook
Affiliation:
University College London
Diane E. Spicer
Affiliation:
University of Florida
Anthony M. Hlavacek
Affiliation:
Medical University of South Carolina
Carl L. Backer
Affiliation:
Cincinnati Children's Hospital
Justin T. Tretter
Affiliation:
Cleveland Clinic, Ohio
Get access

Summary

Over the years, so-called univentricular hearts represented one of the greatest challenges for surgical correction. All this changed with the advent of the Fontan procedure,1 along with the realization that it could become the final stage of the sequence of procedures used to correct lesions such as those included in the hypoplastic left heart syndrome,2 which previously had been beyond surgical repair. The overall group of lesions also posed significant problems in adequate description and categorization. Even these days, many continue to describe patients with a double inlet left ventricle as having a single ventricle, despite the fact that, with the availability of clinical diagnostic techniques producing three-dimensional datasets, patients with this lesion can be seen to have two chambers within their ventricular mass, one being large and the other small (Figure 9.1.1). The semantic problems with description can now be resolved by the simple expedient of describing the patients as having functionally univentricular hearts.3

Type
Chapter
Information
Wilcox's Surgical Anatomy of the Heart , pp. 299 - 406
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References Cited

Fontan, F, Baudet, E. Surgical repair of tricuspid atresia. Thorax 1971; 26: 240–248.CrossRefGoogle ScholarPubMed
Norwood, WI, Lang, P, Hansen, DD. Physiologic repair of aortic atresia – hypoplastic left heart syndrome. NEJM 1983; 308: 23–26.CrossRefGoogle ScholarPubMed
Jacobs, ML, Anderson, RH. Nomenclature of the functionally univentricular heart. Cardiol Young 2006; 16 (Suppl.1): 3–8.CrossRefGoogle ScholarPubMed
Anderson, RH, Macartney, FJ, Tynan, M, et al. Univentricular atrioventricular connection: the single ventricle trap unsprung. Pediatr Cardiol 1983; 4: 273–280.CrossRefGoogle ScholarPubMed
Anderson, RH, Becker, AE, Tynan, M, et al. The univentricular atrioventricular connection: getting to the root of a thorny problem. Am J Cardiol 1984; 54: 822–828.CrossRefGoogle Scholar
Anderson, RH, Ho, SY. What is a ventricle? Ann Thorac Surg 1998; 66: 616–620.CrossRefGoogle ScholarPubMed
Kurosawa, H, Imai, Y, Fukuchi, S, et al. Septation and Fontan repair of univentricular atrioventricular connection. J Thorac Cardiovas Surg 1990; 99: 314–319.CrossRefGoogle ScholarPubMed
Franklin, RCG, Spiegelhalter, DJ, Anderson, RH, et al. Double-inlet ventricle presenting in infancy. I. Survival without definitive repair. J Thorac Cardiovasc Surg 1991; 101: 767–776.CrossRefGoogle ScholarPubMed
Hosseinpour, AR, Anderson, RH, Ho, SY. The anatomy of the septal perforating arteries in normal and congenitally malformed hearts. J Thorac Cardiovasc Surg 2001; 121: 1046–1052.CrossRefGoogle ScholarPubMed
Cheung, HC, Lincoln, C, Anderson, RH, et al. Options for surgical repair in hearts with univentricular atrioventricular connection and subaortic stenosis. J Thorac Cardiovasc Surg 1990; 100: 672–681.CrossRefGoogle ScholarPubMed
Abbott, ME. Unique case of congenital malformation of the heart. Museum Notes. McGill University. 1992: pp. 522–525.Google Scholar
Fontan, F, Kirklin, JW, Fernandez, G, et al. Outcome after a ‘perfect’ Fontan operation. Circulation 1990; 81: 1520–1536.CrossRefGoogle ScholarPubMed
de Leval, MR, Kilner, P, Gewillig, M, Bull, C. Total cavopulmonary connection: a logical alternative to atriopulmonary connection for complex Fontan operations. J Thorac Cardiovasc Surg 1988; 96: 682–695.CrossRefGoogle ScholarPubMed
Marcelletti, C, Corno, A, Giannico, S, Marino, B. Inferior vena cava-pulmonary artery extracardiac conduit: a new form of right heart bypass. J Thorac Cardiovasc Surg 1990; 100: 228–232.CrossRefGoogle ScholarPubMed
Anderson, RH, Arnold, R, Thaper, MK, Jones, RS, Hamilton, DI. Cardiac specialized tissues in hearts with an apparently single ventricular chamber (double inlet left ventricle). Am J Cardiol 1974; 33: 95–106.CrossRefGoogle ScholarPubMed
Keeton, BR, Macartney, FJ, Hunter, S, et al. Univentricular heart of right ventricular type with double or common inlet. Circulation 1979; 59: 403–411.CrossRefGoogle ScholarPubMed
Essed, CE, Ho, SY, Hunter, S, Anderson, RH. Atrioventricular conduction system in univentricular heart of right ventricular type with right-sided rudimentary chamber. Thorax 1980; 35: 123–127.CrossRefGoogle ScholarPubMed
Kiraly, L, Hubay, M, Cook, AC, Ho, SY, Anderson, RH. Morphologic features of the uniatrial but biventricular atrioventricular connection. J Thorac Cardiovasc Surg 2007; 133: 229–234.CrossRefGoogle ScholarPubMed
Orie, JD, Anderson, C, Ettedgui, J, Zuberbuhler, JR, Anderson, RH. Echocardiographic-morphologic correlations in tricuspid atresia. J Am Coll Cardiol 1995; 26: 750–758.CrossRefGoogle ScholarPubMed

References Cited

Jaggers, JJ, Cameron, DE, Herlong, JR, Ungerleider, RM. Congenital Heart Surgery Nomenclature and Database Project: transposition of the great arteries. Ann Thor Surg 2000; 69: 205–235.CrossRefGoogle ScholarPubMed
Wilkinson, JL, Cochrane, AD, Karl, TR. Congenital Heart Surgery Nomenclature and Database Project: corrected (discordant) transposition of the great arteries (and related malformations). Ann Thor Surg 2000; 69: 236–248.CrossRefGoogle ScholarPubMed
Van Praagh, R. What is congenitally corrected transposition? NEJM 1970; 282: 1097–1098.CrossRefGoogle ScholarPubMed
Van Praagh, R. Transposition of the great arteries II. Transposition clarified. Am J Cardiol 1971; 28: 739–741.CrossRefGoogle ScholarPubMed
Walters, HL III, Mavroudis, C, Tchervenkov, CI, et al. Congenital heart surgery nomenclature and database project: double outlet right ventricle. Ann Thor Surg 2000; 69: 249–263.CrossRefGoogle ScholarPubMed
Van Mierop, LHS. Transposition of the great arteries. Clarification or further confusion? Editorial. Am J Cardiol 1971; 28: 735–738.CrossRefGoogle ScholarPubMed
Houyel, L, Van Praagh, R, Lacour-Gayet, F, et al. Transposition of the great arteries {S, D, L}: pathologic anatomy, diagnosis, and surgical management of a newly recognized complex. J Thorac Cardiovasc Surg 1995; 110: 613–624.CrossRefGoogle Scholar
Isaacson, R, Titus, JL, Merideth, J, Feldt, RH, McGoon, DC. Apparent interruption of atrial conduction pathways after surgical repair of transposition of the great arteries. Am J Cardiol 1972; 30: 533–535.CrossRefGoogle Scholar
Ullal, RR, Anderson, RH, Lincoln, C. Mustard’s operation modified to avoid dysrhythmias and pulmonary and systemic venous obstruction. J Thorac Cardiovasc Surg 1979; 78: 431–439.CrossRefGoogle ScholarPubMed
Spicer, DE, Anderson, RH, Backer, CL. Clarifying the surgical morphology of inlet ventricular septal defects. Ann Thor Surg 2013; 95: 236–241.CrossRefGoogle ScholarPubMed
Nikaidoh, H. Nikaidoh procedure: a perspective. Eur J Cardio-Thorac Surg 2016; 50: 1001–1005.CrossRefGoogle ScholarPubMed
Lecompte, Y. Reparation a l’etage ventriculaire – the REV procedure: technique and clinical results. Cardiol Young 1991; 1: 63–70.CrossRefGoogle ScholarPubMed
Prandstetter, C, Tulzer, A, Mair, R, Sames-Dolzer, E, Tulzer, G. Effects of surgical en bloc rotation of the arterial trunk on the conduction system in children with transposition of the great arteries, ventricular septal defect and pulmonary stenosis. Cardiol Young 2016; 26: 516–520.CrossRefGoogle ScholarPubMed
Van Praagh, R, Pérez-Treviño, C, López-Cuellar, M, et al. Transposition of the great arteries with posterior aorta, anterior pulmonary artery, subpulmonary conus and fibrous continuity between aortic and atrioventricular valves. Am J Cardiol 1971; 28: 621–623.CrossRefGoogle ScholarPubMed
Wilkinson, JL, Arnold, R, Anderson, RH, Acerete, F. ‘Posterior’ transposition reconsidered. Br Heart J 1975; 37: 757–766.CrossRefGoogle ScholarPubMed
Shaher, RM, Puddu, GC. Coronary arterial anatomy in complete transposition of the great arteries. Am J Cardiol 1966; 17: 355–361.CrossRefGoogle Scholar
Yacoub, MH, Radley-Smith, R. Anatomy of the coronary arteries in transposition of the great arteries and methods for their transfer in anatomical correction. Thorax 1978; 33: 418–424.CrossRefGoogle ScholarPubMed
Gittenberger-de-Groot, AC, Sauer, U, Oppenheimer-Dekker, A, Quaegebeur, J. Coronary arterial anatomy in transposition of the great arteries: a morphologic study. Pediatr Cardiol 1983; 4: 15–24.Google Scholar
Michalak, KW, Wernovsky, G, Moll, M, Anderson, RH. The black swan: unique coronary arterial anatomy observed in a patient with transposition. J Thorac Cardiovasc Surg 2019; 158: e107–109.CrossRefGoogle Scholar
Lacour-Gayet, F, Anderson, RH. A uniform surgical technique for transfer of both simple and complex patterns of the coronary arteries during the arterial switch procedure. Cardiol Young 2005; 15 (Suppl.1): 93–101.CrossRefGoogle ScholarPubMed
Konstantinov, IE, Fricke, TA, d’Udekem, Y, Radford, DJ. Translocation of a single coronary artery from the nonfacing sinus in the arterial switch operation: long-term patency of the interposition graft. J Thorac Cardiovasc Surg 2010; 140: 1193–1194.CrossRefGoogle ScholarPubMed
Gittenberger-de Groot, AC, Sauer, U, Quaegebeur, J. Aortic intramural coronary artery in three hearts with transposition of the great arteries. J Thorac Cardiovasc Surg 1986; 91: 566–571.CrossRefGoogle ScholarPubMed
Asou, T, Karl, TR, Pawade, A, Mee, RB. Arterial switch: translocation of the intramural coronary artery. Ann Thorac Surg 1994; 57: 461–465.CrossRefGoogle ScholarPubMed
Massoudy, P, Baltalarli, A, de Leval, MR, et al. Anatomic variability in coronary arterial distribution with regard to the arterial switch procedure. Circulation 2002; 106: 1980–1984.CrossRefGoogle Scholar
Anderson, RH, Becker, AE, Arnold, R, Wilkinson, JL. The conducting tissues in congenitally corrected transposition. Circulation 1974; 50: 911–923.CrossRefGoogle ScholarPubMed
Arribard, N, Mostefa Kara, M, Hascoët, S, et al. Congenitally corrected transposition of the great arteries: is it really a transposition? An anatomical study of the right ventricular septal surface. J Anat 2020; 236: 325–333.CrossRefGoogle ScholarPubMed
De Leval, M, Bastos, P, Stark, J, et al. Surgical technique to reduce the risks of heart block following closure of ventricular septal defect in atrioventricular discordance. J Thorac Cardiovasc Surg 1979; 78: 515–526.CrossRefGoogle ScholarPubMed
Anderson, RH, Becker, AE, Gerlis, LM. The pulmonary outflow tract in classically corrected transposition. J Thorac Cardiovasc Surg 1975; 69: 747–757.CrossRefGoogle ScholarPubMed
Becker, AE, Ho, SY, Caruso, G, Milo, S, Anderson, RH. Straddling right atrioventricular valves in atrioventricular discordance. Circulation 1980; 61: 1133–1141.CrossRefGoogle ScholarPubMed
Ilbawi, MN, DeLeon, SY, Backer, CL, et al. An alternative approach to the surgical management for physiologically corrected transposition with ventricular septal defect and pulmonary stenosis or atresia. J Thorac Cardiovasc Surg 1990; 100: 410–415.CrossRefGoogle ScholarPubMed
Imai, Y, Sawatori, K, Hoshino, S, et al. Ventricular function after anatomic repair in patients with atrioventricular discordance. J Thorac Cardiovasc Surg 1994; 107: 1272–1283.CrossRefGoogle ScholarPubMed

References Cited

Walters, HL 3rd, Mavroudis, C, Tchervenkov, CI, et al. Congenital Heart Surgery Nomenclature and Database Project: double outlet right ventricle. Ann Thorac Surg 2000; 69(Suppl.4): S249–263.CrossRefGoogle ScholarPubMed
Paul, MH, Muster, AJ, Sinha, SN, Cole, RB, Van Praagh, R. Double-outlet left ventricle with an intact ventricular septum: clinical and autopsy diagnosis and developmental implications. Circulation 1970; 41: 129–139.CrossRefGoogle ScholarPubMed
Baron, MG. Radiologic notes in cardiology: angiographic differentiation between tetralogy of Fallot and double-outlet right ventricle relationship of the mitral and aortic valves. Circulation 1971; 43: 451–545.CrossRefGoogle ScholarPubMed
Fallot, A. Contribution à l’anatomie pathologique de la maladie bleue (cyanose cardiaque). Marseille Medicale 1888; 25: 77–93.Google Scholar
Ebadi, A, Spicer, DE, Backer, CL, Fricker, FJ, Anderson, RH. Double-outlet right ventricle revisited. J Thorac Cardiovasc Surg 2017; 154: 598–604.CrossRefGoogle ScholarPubMed
Lev, M, Bharati, S, Meng, CCL, et al. A concept of double-outlet right ventricle. J Thorac Cardiovasc Surg 1972; 64: 271–281.CrossRefGoogle ScholarPubMed
Lincoln, C, Anderson, R, Shinebourne, EA, English, TA, Wilkinson, JL. Double outlet right ventricle with 1-malposition of the aorta. Br Heart J 1975; 37: 453–463.CrossRefGoogle ScholarPubMed
Stellin, G, Zuberbuhler, JR, Anderson, RH, Siewers, RD. The surgical anatomy of the Taussig-Bing malformation. J Thorac Cardiovasc Surg 1987; 93: 560–569.CrossRefGoogle ScholarPubMed
Stellin, G, Ho, SY, Anderson, RH, Zuberbuhler, JR, Siewers, RD. The surgical anatomy of double-outlet right ventricle with concordant atrioventricular connection and non-committed ventricular septal defect. J Thorac Cardiovasc Surg 1991; 102: 849–855.CrossRefGoogle Scholar
Lacour-Gayet, F, Haun, C, Ntalakoura, K, et al. Biventricular repair of double outlet right ventricle with non-committed ventricular septal defect (VSD) by VSD rerouting to the pulmonary artery and arterial switch. Eur J Cardiothorac Surg 2002; 21: 1042–1048.CrossRefGoogle Scholar
Hosseinpour, A-R, Jones, TJ, Barron, DJ, Brawn, WJ, Anderson, RH. An appreciation of the structural variability in the components of the ventricular outlets in congenitally malformed hearts. Eur J Cardio-thorac Surg 2007; 31: 888–893.CrossRefGoogle ScholarPubMed

References Cited

Collett, RW, Edwards, JE. Persistent truncus arteriosus. A classification according to anatomic types. Surg Clin North Am 1949; 29: 1245–1270.CrossRefGoogle ScholarPubMed
Russell, HM, Jacobs, ML, Anderson, RH, et al. A simplified categorization for common arterial trunk. J Thorac Cardiovasc Surg 2011; 141: 645–653.CrossRefGoogle ScholarPubMed
Anderson, RH, Thiene, G. Categorization and description of hearts with common arterial trunk. Eur J Cardio-thorac Surg 1989; 3: 481–487.CrossRefGoogle ScholarPubMed
Schofield, DE, Anderson, RH. Common arterial trunk with pulmonary atresia. Int J Cardiol 1988; 20: 290–294.CrossRefGoogle ScholarPubMed
Kramer, TC. The partitioning of the truncus and conus and the formation of the membranous portion of the interventricular septum in the human heart. Am J Anat 1942; 71: 343–370.CrossRefGoogle Scholar
Anderson, RH, Mohun, TJ, Spicer, DE, et al. Myths and realities relating to development of the arterial valves. J Cardiovasc Devel Dis 2014; 1: 177–200.Google Scholar
Spicer, DE, Steffensen, TS. A rare presentation of common arterial trunk with intact ventricular septum. J Cardiovasc Devel Dis 2020; 7: 43.Google ScholarPubMed
Van Praagh, R, Van Praagh, S. The anatomy of common aorticopulmonary trunk (truncus arteriosus communis) and its embryologic implications: a study of 57 necropsy cases. Am J Cardiol 1965; 16: 406–425.CrossRefGoogle ScholarPubMed
Van Mierop, LHS, Patterson, DF, Schnarr, WR. Pathogenesis of persistent truncus arteriosus in light of observations made in a dog embryo with the anomaly. Am J Cardiol 1978; 41: 755–762.CrossRefGoogle Scholar
Garg, P, Mishra, A, Shah, R, Parmar, D, Anderson, RH. Neonatal repair of common arterial trunk with intact ventricular septum. World J Pediatr Congenit Heart Surg 2015; 6: 93–97.CrossRefGoogle ScholarPubMed
Tsang, VT, Kang, N, Sullivan, I, Marek, J, Anderson, RH. Ventriculoarterial septal defect with separate aortic and pulmonary valves, but common ventriculoarterial junction. J Thorac Cardiovasc Surg 2008; 135: 222–223.CrossRefGoogle ScholarPubMed
Adachi, I, Ho, SY, Bartelings, MM, et al. Common arterial trunk with atrioventricular septal defect: new observations pertinent to repair. Ann Thorac Surg 2009; 87: 1495–1499.CrossRefGoogle ScholarPubMed
Carr, I, Bharati, S, Kusnoor, VS, Lev, M. Truncus arteriosus communis with intact ventricular septum. Br Heart J 1979; 42: 97–102.CrossRefGoogle ScholarPubMed
Backer, CL. Techniques for repairing the aortic and truncal valves. Cardiol Young 2005; 15 (Suppl.1): 125–131.CrossRefGoogle ScholarPubMed
Rubay, JE, Macartney, FJ, Anderson, RH. A rare variant of common arterial trunk. Br Heart J 1987; 57: 202–204.CrossRefGoogle ScholarPubMed
Sekelyk, RI, Yusifli, IB, Kozhokar, DM, et al. Surgical repair of a rare variant of common arterial trunk, with considerations of its significance for morphogenesis. World J Ped Card Surg 2023; 14: 446–450.Google ScholarPubMed
Adachi, I, Uemura, H, McCarthy, KP, Seale, A, Ho, SY. Relationship between orifices of pulmonary and coronary arteries in common arterial trunk. Eur J Cardiothorac Surg 2009; 35: 594–599.CrossRefGoogle ScholarPubMed
Gupta, SK, Aggarwal, A., Shaw, M, et al. Clarifying the anatomy of common arterial trunk: a clinical study of 70 patients. Eur Heart J-Cardiovasc Imag 2020; 21, 914–922.CrossRefGoogle ScholarPubMed
Suzuki, A, Ho, SY, Anderson, RH, Deanfield, JE. Coronary arterial and sinusal anatomy in hearts with a common arterial trunk. Ann Thorac Surg 1989; 48: 792–797.CrossRefGoogle ScholarPubMed
Bogers, AJ, Bartelings, MM, Bokenkamp, R, et al. Common arterial trunk, uncommon coronary arterial anatomy. J Thorac Cardiovasc Surg 1993; 106; 1133–1137.CrossRefGoogle ScholarPubMed

References Cited

Van Mierop, LHS, Wiglesworth, FW. Pathogenesis of transposition complexes. II. Anomalies due to faulty transfer of the posterior great artery. Am J Cardiol 1963; 12:226–232.Google Scholar
Van Praagh, R, Van Praagh, S. Isolated ventricular inversion: a consideration of the morphogenesis, definition and diagnosis of nontransposed and transposed great arteries. Am J Cardiol 1966; 17: 395–406.CrossRefGoogle ScholarPubMed
Van Praagh, R, Durnin, RE, Jockin, H, et al. Anatomically corrected malposition of the great arteries (S, D, L). Circulation. 1975; 51: 20–31.CrossRefGoogle ScholarPubMed
Bernasconi, A, Cavalle-Garrido, T, Perrin, DG, Anderson, RH. What is anatomically corrected malposition? Cardiol Young 2007; 17: 26–34.CrossRefGoogle ScholarPubMed
Cavalle-Garrido, T, Bernasconi, A, Perrin, D, Anderson, RH. Hearts with concordant ventriculoarterial connections but parallel arterial trunks. Heart 2007; 93: 100–106.CrossRefGoogle ScholarPubMed
Macartney, FJ, Shinebourne, EA, Anderson, RH. Connexions, relations, discordance and distortions. Br Heart J 1976; 38: 323–326.CrossRefGoogle Scholar
Van Praagh, R, Van Praagh, S. Anatomically corrected transposition of the great arteries. Br Heart J 1967; 29: 112.CrossRefGoogle ScholarPubMed
Van Praagh, R, Pérez-Treviño, C, López-Cuellar, M, et al. Transposition of the great arteries with posterior aorta, anterior pulmonary artery, subpulmonary conus and fibrous continuity between aortic and atrioventricular valves. Am J Cardiol 1971; 28: 621–631.CrossRefGoogle ScholarPubMed
Van Mierop, LH. Transposition of the great arteries. I. Clarification or further confusion? Am J Cardiol 1971; 28: 735–738.CrossRefGoogle ScholarPubMed
Freedom, RM, Harrington, DP. Anatomically corrected malposition of the great arteries. Report of 2 cases, one with congenital asplenia; frequent association with juxtaposition of atrial appendages. Br Heart J 1974; 36: 20–26.CrossRefGoogle ScholarPubMed
Lincoln, C, Anderson, R, Shinebourne, EA, English, TA, Wilkinson, JL. Double outlet right ventricle with 1-malposition of the aorta. Br Heart J 1975; 37: 453–463.CrossRefGoogle ScholarPubMed
Anderson, RH, Becker, A, Losekoot, TG, Gerlis, LM. Anatomically corrected malposition of great arteries. Br Heart J 1975; 37: 993–1013.CrossRefGoogle ScholarPubMed
Salazar, J, López, C, Felipe, J, et al. Anatomically corrected malposition of the great arteries in situs ambiguous with polysplenia. Ped Cardiol 1985; 6: 53–55.CrossRefGoogle Scholar
Chowdhury, UK, Anderson, RH, Spicer, DE, et al. Transposition physiology in the setting of concordant ventriculo‐arterial connections. J Card Surg 202; 37: 2823–2834.CrossRefGoogle Scholar
Freedom, RM, Nanton, M, Dische, MR. Isolated ventricular inversion with double inlet left ventricle. Eur J Cardiol 1977; 5: 63–86.Google ScholarPubMed
Laux, D, Houyel, L, Bajolle, F, et al. Problems in the diagnosis of discordant atrioventricular with concordant ventriculo-arterial connections: anatomical considerations, surgical management, and long-term outcome. Cardiol Young 2016; 26: 127–138.CrossRefGoogle ScholarPubMed
Sharma, R, Marwah, A, Shah, S, Maheshwari, S. Isolated atrioventricular discordance: surgical experience. Ann Thorac Surg 2008; 85: 1403–1406.CrossRefGoogle ScholarPubMed
Santoro, G, Masiello, P, Farina, R, et al. Isolated atrial inversion in situs inversus: a rare anatomic arrangement. Ann Thorac Surg 1995; 59: 1019–1021.CrossRefGoogle ScholarPubMed
Smith, A, Ho, SY, Anderson, RH, et al. The diverse cardiac morphology seen in hearts with isomerism of the atrial appendages with reference to the disposition of the specialised conduction system. Cardiol Young 2006; 16: 437–454.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×