{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:12:45Z","timestamp":1761822765220,"version":"3.41.0"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2005,4,14]],"date-time":"2005-04-14T00:00:00Z","timestamp":1113436800000},"content-version":"unspecified","delay-in-days":103,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:p>In a prospective audit of consecutive referrals for fetal echocardiography between 1997 and 2003, we documented all instances of an abnormal arrangement of the abdominal vessels. We then established the structure of the heart in these fetuses, noting any extra-cardiac associations, and the eventual outcomes.<\/jats:p>\n\t  <jats:p>We found a cardiac abnormality in 572 of the 2,136 fetuses examined during this period (27 percent), with 16 (0.8 percent) having an abnormal arrangement of the abdominal great vessels. Mirror-imaged arrangement was found in 3, while the arrangement suggested right isomerism in 6, and left isomerism in 7. Of these 16 fetuses, 14 had cardiac malformations. Isomerism of the right atrial appendages was found in 7 fetuses, all with either a right-sided stomach or cardiac apex, and 6 with a common atrioventricular junction guarded by a common valve. Only 1 of these fetuses survived. Of the 3 fetuses with mirror-imaged abdominal great vessels, 2 also had mirror-imaged atrial arrangement, while the 3rd had isomeric right appendages. Only one of 7 fetuses with an abdominal great vein posterior to the aorta had bilateral left atrial appendages. The remaining 6 had usual atrial arrangement, with normal pulmonary venous connections in all but one, who had infra-diaphragmatic totally anomalous pulmonary venous connection. Of these fetuses, 2 had coarctation of the aorta, and 2 others had complex cardiac malformations resulting in neonatal death. One died in childhood from biliary atresia, and three are alive.<\/jats:p>\n\t  <jats:p>Abnormal arrangements of the abdominal great vessels, therefore, were found in 0.8 percent of our total fetuses, and in 2.4 percent of those with cardiac malformations. Those with an abnormal arrangement of the abdominal vessels combined with an abnormal arrangement of the atrial appendages, however, made up only 0.5 percent and 1.6 percent, respectively. While screening for an abnormal arrangement of the abdominal vessels overestimated the incidence of left, but not right, isomerism of the atrial appendages, it did predict the presence of important extra-cardiac malformations that required urgent recognition and management after birth.<\/jats:p>","DOI":"10.1017\/s1047951105000089","type":"journal-article","created":{"date-parts":[[2005,4,14]],"date-time":"2005-04-14T14:25:05Z","timestamp":1113488705000},"page":"35-42","source":"Crossref","is-referenced-by-count":5,"title":["The implications for fetal outcome of an abnormal arrangement of the abdominal vessels"],"prefix":"10.1017","volume":"15","author":[{"given":"Lucia","family":"Pasquini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tony","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siew","family":"Yen Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Gardiner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2005,4,14]]},"reference":[{"key":"S1047951105000089_ref007","doi-asserted-by":"crossref","unstructured":"Anderson C , Devine WA , Anderson RH , Debich DZ , Zuberbuhler JR . Abnormalities of the spleen in relation to congenital malformations of the heart: a survey of necropsy findings in children. Br Heart J 1990; 63: 122\u2013128.","DOI":"10.1136\/hrt.63.2.122"},{"key":"S1047951105000089_ref008","doi-asserted-by":"crossref","unstructured":"Splitt MP , Burn J , Goodship J . Defects in the determination of left-right asymmetry. J Med Genet 1996; 33: 498\u2013503.","DOI":"10.1136\/jmg.33.6.498"},{"key":"S1047951105000089_ref012","doi-asserted-by":"crossref","unstructured":"Gilljam T , McCrindle BW , Smallhorn JF , Williams WG , Freedom RM . Outcomes of left atrial isomerism over a 28-year period at a single institution. J Am Coll Cardiol 2000; 36: 908\u2013916.","DOI":"10.1016\/S0735-1097(00)00812-3"},{"key":"S1047951105000089_ref003","unstructured":"Ferencz C , Loffredo CA , Correa-Villasenor A , Wilson PD (eds). Defects of laterality and looping. In: Genetic and Environmental Risk Factors of Major Cardiovascular Malformations: The Baltimore-Washington Infant Study 1981\u20131989. Futura Publishing Company, Inc., Armonk, NY, 1997, pp 41\u201357."},{"key":"S1047951105000089_ref001","doi-asserted-by":"crossref","unstructured":"Shinebourne EA , Macartney FJ , Anderson RH . Sequential segmental localization \u2013 logical approach to diagnosis in congenital heart disease. Br Heart J 1976; 38: 327\u2013340.","DOI":"10.1136\/hrt.38.4.327"},{"key":"S1047951105000089_ref006","doi-asserted-by":"crossref","unstructured":"Caruso G , Becker AE . How to determine atrial situs? Considerations initiated by three cases of absent spleen with a discordant anatomy between bronchi and atria. Br Heart J 1979; 41: 559\u2013567.","DOI":"10.1136\/hrt.41.5.559"},{"key":"S1047951105000089_ref004","doi-asserted-by":"crossref","unstructured":"Lin AE , Ticho BS , Houde K , Westgate M-N , Holmes LB . Heterotaxy: associated conditions and hospital-based prevalence in newborns. Genetics in Medicine 2000; 2: 157\u2013172.","DOI":"10.1097\/00125817-200005000-00002"},{"key":"S1047951105000089_ref009","doi-asserted-by":"crossref","unstructured":"Yagel S , Cohen SM , Achiron R . Examination of the fetal heart by five short-axis views: a proposed screening method for comprehensive cardiac evaluation. Ultrasound Obstet Gynecol 2001; 17: 367\u2013369.","DOI":"10.1046\/j.1469-0705.2001.00414.x"},{"key":"S1047951105000089_ref010","doi-asserted-by":"crossref","unstructured":"Uemura H , Ho SY , Devine WA , Kilpatrick LL , Anderson RH . Atrial appendages and venoatrial connections in hearts from patients with visceral heterotaxy. Ann Thorac Surg 1995; 60: 561\u2013569.","DOI":"10.1016\/0003-4975(95)00538-V"},{"key":"S1047951105000089_ref005","unstructured":"Riopel DA . The heart: Visceral situs and looping defects. In: Stevenson RE , Hall JG , Goodman RM (eds). Human Malformations and Related Anomalies. Oxford University Press, New York, 1993, pp 307\u2013321."},{"key":"S1047951105000089_ref015","doi-asserted-by":"crossref","unstructured":"Applegate KE , Goske MJ , Pierce G , Murphy D . Situs revisited: imaging of the heterotaxy syndrome. Radiographics 1999; 19: 837\u2013852.","DOI":"10.1148\/radiographics.19.4.g99jl31837"},{"key":"S1047951105000089_ref016","doi-asserted-by":"crossref","unstructured":"McKiernan PJ , Baker AJ , Kelly DA . The frequency and outcome of biliary atresia in the UK and Ireland. Lancet 2000; 355: 25\u201329.","DOI":"10.1016\/S0140-6736(99)03492-3"},{"key":"S1047951105000089_ref002","unstructured":"Ho SY , Baker EJ , Rigby ML , Anderson RH (eds). Isomerism of atrial appendages. In: Color Atlas of Congenital Heart Disease. Morphologic and Clinical Correlations. Mosby-Wolfe, London, 1995, pp 45\u201354."},{"key":"S1047951105000089_ref014","doi-asserted-by":"crossref","unstructured":"Chandra RS . Biliary atresia and other structural anomalies in congenital polysplenia syndrome. J Pediatr 1974; 85: 649\u2013655.","DOI":"10.1016\/S0022-3476(74)80508-1"},{"key":"S1047951105000089_ref013","doi-asserted-by":"crossref","unstructured":"Phoon CK , Villegas MD , Ursell PC , Silverman NH . Left atrial isomerism detected in fetal life. Am J Cardiol 1996; 77: 1083\u20131088.","DOI":"10.1016\/S0002-9149(96)00137-3"},{"key":"S1047951105000089_ref011","doi-asserted-by":"crossref","unstructured":"Fyler DC , Buckley LP , Hellenbrand WE , Cohn HE . Report of the New England Regional Infant Care Programme. 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