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DEXTRAPOSITION OF THE
FETAL HEART
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Dextraposition of the fetal heart is defined as:
- A heart located on the
right side of the fetal chest.
- Apex of the heart points to
the left.
- Normal connection to the
aorta and pulmonary arteries.
- Compression of the fetal
heart and mediastinum, with shifting of the
heart towards the right side of the fetus (1).
- Congenital Bochdalek
hernia on the left side The cardiac shift is due to the presence of the
stomach and intestinal contents in the chest cavity.
- Congenital cystic adenomatoid malformation of the lung.
- Hypoplasia
of the right lung, with a resultant shift of the heart to the right
filling the void in the right hemithorax (1).
This may occur in conjunction with the Scimitar Syndrome:
- Dextraposition
of the heart.
- Maldevelopment
of the right lung.
- Anomalous right
pulmonary venous connection (partial or complete), typically to the IVC,
portal vein, hepatic vein or the right atrium (2).
- Anomalous arterial
supply to the right lower lung (usually from the abdominal aorta).
- Pulmonary veins drain
into the IVC (2).
- Holt-Oram
syndrome in combination with reciprocal translocation between chromosome 1
and 11 (1p13, 11q13), right lung hypoplasia
and cardiomyopathy
has been reported (3).
- AV Canal defect (29%) (1).
- Diaphragmatic hernia (21%)
(1).
- Aneuploidy
(14%) (1).
- Tracheo-esophageal fistula.
- Vertebral
and limb defects (4).
- Cardiovascular
defects (absent or anomalous pulmonary arteries and interruption or
deviation of the aortic arch).
- Borgida
AF, Odibo A, Egan JFX et.al.
Clinical and ultrasonographic features of dextraposition of the fetal heart. Am J Obstet Gynecol 1998;179:982-984.
- Grisaru
D, Achiron R, Lipitz S
et.al. Antenatal sonographic
findings associated with scimitar syndrome. Ultrasound Obstet
Gynecol 1996;8:131-133.
- Kullmann F, Koch R, Feichtinger
W et.al. Holt-Oram
syndrome in combination with reciprocal translocation, lung hypoplasia and cardiomyopathy.
Klin Padiatr 1993;205:185.
- Yancey
MK, Richards DS. Antenatal sonographic findings
associated with unilateral pulmonary agenesis. Obstet
Gynecol 1993;81:847.