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The Annals of Thoracic Surgery, Vol 35, 400-405, Copyright © 1983 by The Society of Thoracic Surgeons

ARTICLES

Right and left isomerism: the cardiac surgeon's view

C Marcelletti, R Di Donato, A Nijveld, C Squitieri, AH Bulterijs, M Naeff, J Schuller and AE Becker

We have treated by palliative or corrective surgery 12 patients with the complex cardiovascular anomalies associated with right isomerism (asplenia syndrome) or left isomerism (polysplenia syndrome). A systemic-pulmonary artery shunt was performed in 4 patients, with 2 early deaths. Anatomical intracardiac repair was successfully done in 2 patients, while an orthoterminal repair using a modified Fontan procedure was attempted in 5 patients, only 1 of whom survived. A 1- year-old girl with diffuse pulmonary arteriovenous fistulas associated with left isomerism was not considered a good candidate for operation after an exploratory sternotomy. The surgical options and technical problems related to the complex intracardiac morphology of these developmental syndromes are presented.

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