Classifying Cardiac Anomalies in Right and Left Isomerism:Concordant and Discordant Patterns

Aims:Evidence is emerging that,in the setting of isomerism,the atrial and bronchial arrangement are not always concordant,nor are these patterns always harmonious with the arrangement of the abdominal organs.We aimed to evaluate the concordance between these features in a cohort of patients with cardiac malformations in the setting of known isomerism,seeking to determine whether it was feasible to assess complexity on this basis,in this regard taking note of the potential value of bronchial as opposed to appendage morphology.Methods and Results:We studied 78 patients known to have isomerism of the bronchuses,43 with right and 35 with left isomerism.Appendage anatomy could be determined in 49 cases(63%),all but one of these being concordant with bronchial anatomy.When assessing abdominal features,in only 59 cases(76%)was splenic morphology in keeping with the thoracic findings.As expected,right isomerism was associated with greater complexity of cardiac malformations,with an odds ratio of 6.53,with confidence intervals from 2.2–19.3(p<0.001).The odds were slightly decreased with thoraco-abdominal disharmony,when lesions shown to carry higher risk were then found in the setting of left isomerism.Conclusion:Harmony is excellent between bronchial and appendage isomerism,but less so with the arrangement of the abdominal organs.Right isomerism in our cohort,was indicative of a sixfold increase in intracardiac complexity.When discordance was found between the systems,however,the cardiac anomalies were less typical of the anticipated findings for right vs.left isomerism of the appendages.

如何预防新生儿先天性出生缺陷

2015年3月3日,“世界出生缺陷日”被首次确立,其主要目的是提高全世界对先天性缺陷的认识,促进并整合有关预防和治疗先天性畸形的行动。“世界出生缺陷日”的设立是为改善生育质量,以及提升产妇、新生儿、儿童和青少年的健康所采取的举措。并非所有出生缺陷都可以预防,但可以通过采取一些措施来帮助每一位母亲拥有一个健康的孕期。在世界各地,数以千计的出生缺陷病例都与公共卫生相关状况有着紧密联系。特别是在工业化社会,以及在不断涌现的新兴工业化国家中,出生缺陷是婴儿在一岁以内发病和死亡的主要原因之一。