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Spectrum of congenital cardiac malformations in dextrocardia: A single institute study

Introduction: Complex congenital heart malformations are associated with dextrocardia depending on the situs. The objective is to present the spectrum of cardiac malformations and the surgical interventions done in patients with dextrocardia at our tertiary care institute over 5 years. Material and Methods: A retrospective study of patients with dextrocardia undergoing some form of cardiac surgery at our institute from January 2012 to December 2016 was done. Seventeen cases were identified, and their records were reviewed. Results: Of 2231 cardiac surgeries done for congenital heart disease, there were 17 (0.76%) patients with dextrocardia with male predominance (70.58%). The mean age was 5.69 ± 6.66 years. Of 17 patients, 9 had situs inversus, 7 had situs solitus, and 1 patient had situs ambiguous. Thirteen patients (76.47%) had functional single-ventricle physiology. Six of them (46.15%) had situs solitus, 6 (46.15%) had situs inversus, and situs ambiguous in 1 (7.69%). Biventricular repair was possible in 4 patients (23.52%), of which 3 had situs inversus and 1 had situs solitus. Three patients had ventriculoarterial (VA) discordance and 2 had atrioventricular and VA discordance. There were two early mortalities and three late mortalities, all of them had single-ventricle physiology. Discussion and Conclusion: Dextrocardia is a rare congenital anomaly with wide variations of complex congenital cardiac malformations. It is associated with all forms of spatial relationships of visceral organs with situs inversus being the most common.