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Left atrial isomerism

Sivasamy Manohar, MD.

Article Published: Apr 22, 2011

Madurai, India.

Case report

The ultrasound exam at 23 weeks revealed the following findings:

  • Stomach on the right side
  • Cardiac apex on the left
  • Complete atrioventricular septal defect
  • Azygos continuity with inferior vena cava interruption
  • Symmetric liver

The above findings were consistent with left atrial isomerism.

Images 1,2: Image 1 shows the stomach on the right side. Image 2 shows the transverse view of the thorax at the level of the 4-chamber view, arrows indicate aorta and azygos vein (double vessels in front of the spine).
Heterotaxy_Manohar_1
Heterotaxy_Manohar_2

Images 3,4: Image 3 shows a coronal view of the thorax with azygos vein (Az) and aorta (Ao) running side by side. Image 4 shows a 4-chamber view with a complete atrioventricular septal defect.

Heterotaxy_Manohar_3
Heterotaxy_Manohar_4

Images 5,6: 4-chamber view with a complete atrioventricular septal defect, note azygos vein (Az) and aorta (Ao) in front of the spine.

Heterotaxy_Manohar_5
Heterotaxy_Manohar_6

Images 7: Stomach on the right.

Heterotaxy_Manohar_7

Videos 1: Color Doppler showing the interruption of the inferior vena cava.

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