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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:361-365 • 0278-4297

Case Series

Isolated Levocardia

Prenatal Diagnosis, Clinical Importance, and Literature Review

Liat Gindes, MD, Julian Hegesh, MD, Gad Barkai, MD, Jeffrey M. Jacobson, MD and Reuven Achiron, MD

Departments of Obstetrics and Gynecology (L.G., G.B., R.A.) and Pediatric Cardiology (J.H.) and Pediatric Unit, Department of Diagnostic Imaging (J.M.J.), Chaim Sheba Medical Center, Tel Hashomer, Israel; affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Address correspondence to Liat Gindes, MD, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, 52621 Tel Hashomer, Israel. E-mail: gindesl{at}zahav.net.il

Objective. Isolated levocardia is a rare type of situs inversus in which the heart is in the normal levo position, but the abdominal viscera are in the dextro position. We aim to describe our experience with prenatal diagnosis and management in fetuses with isolated levocardia. Methods. Of all the cases referred to our tertiary ultrasound unit, 3 cases of isolated levocardia were diagnosed. Patients and fetuses were evaluated every 4 weeks until delivery and postnatally. Results. Two of the 3 fetuses had interruption of the inferior vena cava with azygous continuation. However, postnatal evaluation revealed polysplenia in 1 neonate and asplenia in another. Polysplenia was also diagnosed in the third neonate, who had a normal inferior vena cava on antenatal examination. One neonate had a small ventricular septal defect. Conclusions. Fetal isolated levocardia is associated with a good outcome, in which other malformations are excluded. Therefore, we suggest conservative management in such cases.

Key Words: dextrogastria • levocardia • outcome

Abbreviations: IVC, inferior vena cava • SVC, superior vena cava

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Copyright © 2007 by the American Institute of Ultrasound in Medicine.