Pathologic anatomy of dextrocardia and its clinical implications

This is a morphologic study of 41 cases of dextrocardia for the purpose of clarifying terminology and evaluating the clinical import of the morphologic data. Dextrocardias are classified as dextroversion, mirror-image dextrocardia, and mixed dextrocardia. When the atrial septum does not identify the atria, it was found possible to make the presumptive diagnosis of dextroversion or mirror-image dextrocardia. The mutual relations of the visceral situs with the atrial situs, the presence or absence of splenic abnormalities, the type of dextrocardia, and the systemic and pulmonic venous return were investigated, as well as the type of complex that is characteristic of each type of dextrocardia. The most important morphologic data useful for clinical application were found to be the position of the aortic and pulmonic annuli, the course of the pulmonary trunk, the entry of the inferior and superior venae cavae, and the course of the anterior descending coronary artery.