Andersons pediatric cardiology 681
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FIG.26.2 Essenceoftheusualbodyarrangement(left)anditsmirror
image(right).Individualswiththesearrangementswouldexhibit
enantiomerismrelativetoeachother.LAA,Leftatrialappendage;RAA,
rightatrialappendage.
FIG.26.3 Short-axisviewofthebaseoftheheartillustratingan
unbalancedcommonatrioventricularjunctionwithacommon
atrioventricularvalveandrightdominance.Theinterventricularseptum
(yellowdots)iseasilyappreciated.Thepectinatemusclesextendaround
bothatrioventricularjunctionstothecruxoftheheart(star)inthispatient
withisomerismoftherightatrialappendages.
FIG.26.4 Triangularappendages(stars)ontheright(A)andleft(B)sides
inapatientwithrightisomerism.Notethebilateralsuperiorcavalveinsand
thepulmonaryveinscomingtogetherinamidlineconfluence.Theyellow
dotsshowthebilateralterminalgrooves.
FIG.26.5 Short-axisviewofthebaseoftheheartillustratingacommon
atrioventricularjunctionwithacommonatrioventricularvalvethathas
separaterightandleftorifices.Thebridgingleafletsareadherenttothe
interventricularseptumandtooneanother.Theatrialappendagesare
bilaterallymorphologicallyleftwiththecharacteristictubularappearance
andthenarroworconstrictedjunction(arrows)tothesmooth-walled
vestibules.Notetheleft-sidedpersistentleftsuperiorcavalvein(LSCV).
FIG.26.6 Atrialappendages(stars)totheright(A)andleft(B)sidesofa
patientwithvisceralheterotaxy.Itiseasyinthisinstancetorecognizethat
botharemorphologicallyleftsimplyfromtheirexternalappearance.Note
thebilateralsuperiorcavalveins.
FIG.26.7 Typicalbodilyarrangementsinthesettingofvisceral
heterotaxy.Ineachinstance,insofarasthethoracicstructuresare
