Retrospective review of right-sided hearts and associated cardiac malformations in children at the Chris Hani Baragwanath academic hospital

A research report submitted to the Faculty of Health Science, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Masters of Medicine in Paediatrics (MMed) Johannesburg, 2014Right-sided hearts have three different causes. They are often associated with additional significant cardiac malformations (ASCM) and extracardiac abnormalities. Objectives - To determine the prevalence of right-sided hearts. - To distinguish between dextrocardia, dextroversion and dextroposition. - To examine patient demographics. - To examine ASCM and extracardiac abnormalities. - To document patient management. Methods A retrospective audit of patient records. Results Dextrocardia comprised 1.8% of all congenital heart defects and 58% of all right-sided hearts seen. Situs inversus was the dominant situs arrangement. Situs solitus and situs ambiguous had a high incidence of ASCM. Dextroposition made up 41% of all right-sided hearts and the majority had causes amenable to treatment. Two patients were diagnosed with dextroversion. Conclusions Dextrocardia as a cause of a right-sided heart shows no socioeconomic or ethnic preference. ASCM are commonly seen in dextrocardia, and depends largely on the situs arrangement. Dextroposition is mostly secondary to extracardiac causes. Dextroversion is rare. It is imperative to ascertain the cause of a right-sided heart, as this will influence patient management and outcome