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Authors

Naif Saad ALGhasab, Department of Internal Medicine, Medical Collage, University of Ha’il’, Ha’il, Saudi ArabiaFollow
Bandar Alshehri, Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
Sulaman ALMesned, Department of Emergency, Critical Care and Anesthesia, College of Medicine, Qassim University, Buraidah, Saudi Arabia
Hassan Harbi, Department of Cardiology, King Saud Medical City, Riyadh, Saudi Arabia
Reem ALAmeer, Transplant Infectious Disease, Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
Fahad ALShehri, Department of Internal Medicine, Addiriyah Hospital, Riyadh, Saudi Arabia
Ahmad ALZeid, Department of Internal Medicine, Addiriyah Hospital, Riyadh, Saudi Arabia
Meshari ALZhrani, Transplant Infectious Disease, Organ Transplant Center, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
Ghazi T. ALMutiri, Adult Critical Care Medicine Department, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
Sara Abou Al-Saud, Cardiac Sciences Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Fahad Alobaid, Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
Khalid S. Alnajashi, Department of Pediatric Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
Federica Fogacci, Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
Arrigo F.G. Cicero, Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
Suleiman M. Kharabsheh, Department of Cardiology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

Abstract

Objective: The right-sided positioning of heart during embryonic development is termed dextrocardia, and it may be isolated or associated with visceral dextroposition or malformation. However, there are few studies on the condition. This study aimed to determine the incidence of cardiac and non-cardiac malformations, long-term follow-up, and survival analysis of patients with dextrocardia. Methods: This was a retrospective chart review of dextrocardia cases at King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia from April 22, 1975, to December 31, 2016. A total of 259,246 transthoracic echocardiograms from that period were reviewed, and 357 patients were included in the analysis. Results: The incidence of dextrocardia was approximately 1 in 28,571 pregnancies (0.35 per 10,000 pregnancies). Most patients with dextrocardia were between 2–18 years old (n= 252, 70.6%). The most common type was isolated dextrocardia (situs solitus), followed by situs inversus totalis, and situs ambiguous. The most common congenital cyanotic heart diseases were double outlet right ventricle (n=55, 15.5%) and pulmonary atresia (n=35, 9.8%). The most common acyanotic congenital abnormalities were ventricular (n=152, 42.7%) and atrial (n=121, 34.2%) septal defects. Overall survival in the study population was approximately 83%. Survival rates varied by situs type, with the highest rates observed in patients with situs inversus (96%), followed by those with situs solitus (91%), and situs ambiguous (55%). Moderate to severe pulmonary hypertension was significantly associated with a reduction in overall survival. The most common non-cardiac anomalies observed were gastrointestinal and urogenital abnormalities. Conclusion:This study describes the largest regional cohort of patients with dextrocardia, providing important insights into dextrocardia and outcomes of different intracardiac defects in our community. Our findings confirm that complex congeni

Objective: The right-sided positioning of heart during embryonic development is termed dextrocardia, and it may be isolated or associated with visceral dextroposition or malformation. However, there are few studies on the condition. This study aimed to determine the incidence of cardiac and non-cardiac malformations, long-term follow-up, and survival analysis of patients with dextrocardia. Methods: This was a retrospective chart review of dextrocardia cases at King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia from April 22, 1975, to December 31, 2016. A total of 259,246 transthoracic echocardiograms from that period were reviewed, and 357 patients were included in the analysis. Results: The incidence of dextrocardia was approximately 1 in 28,571 pregnancies (0.35 per 10,000 pregnancies). Most patients with dextrocardia were between 2–18 years old (n= 252, 70.6%). The most common type was isolated dextrocardia (situs solitus), followed by situs inversus totalis, and situs ambiguous. The most common congenital cyanotic heart diseases were double outlet right ventricle (n=55, 15.5%) and pulmonary atresia (n=35, 9.8%). The most common acyanotic congenital abnormalities were ventricular (n=152, 42.7%) and atrial (n=121, 34.2%) septal defects. Overall survival in the study population was approximately 83%. Survival rates varied by situs type, with the highest rates observed in patients with situs inversus (96%), followed by those with situs solitus (91%), and situs ambiguous (55%). Moderate to severe pulmonary hypertension was significantly associated with a reduction in overall survival. The most common non-cardiac anomalies observed were gastrointestinal and urogenital abnormalities. Conclusion: This study describes the largest regional cohort of patients with dextrocardia, providing important insights into dextrocardia and outcomes of different intracardiac defects in our community. Our findings confirm that complex congenital cardiac disease is more common in patients with situs solitus and isomerism group. Patients in the isomerism group (12.6%) had significantly higher mortality rates compared to those in the situs solitus (7.6%) and situs inversus (3.7%) groups.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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