De Tommasi S, Daliento L, Ho S Y, Macartney F J, Anderson R H
Br Heart J. 1981 Mar;45(3):236-47. doi: 10.1136/hrt.45.3.236.
We have analysed the atrioventricular junction, ventricular mass, and ventriculoarterial junction in 43 hearts with isomeric atrial chambers. Of the hearts, 32 had atrial chambers of bilateral right morphology while 11 had atrial chambers with bilateral left atrial characteristics. Among the hearts with right atrial isomerism, there were 13 biventricular hearts, all with ambiguous atrioventricular connection. Eight had a common valve and five had two atrioventricular valves. In the other 19 hearts, the atrial chambers were connected to only one ventricular chamber, 18 having double inlet ventricle through a common valve and the other having absence of the left atrioventricular connection. In these univentricular hearts, all possible types of ventricular morphology were found. The ventriculoarterial junction among these hearts with right isomerism showed great variation. In the hearts with left atrial isomerism, nine hearts had two ventricles and two were univentricular. The biventricular hearts all had ambiguous atrioventricular connection, six via a common valve and three via two valves. The two univentricular hearts both had double inlet via a common valve, one to a chamber of right ventricular type and the other to a chamber of left ventricular type. Both had rudimentary chambers of complementary pattern. The ventriculoarterial junction again showed much variation. Statistical analysis showed that pulmonary obstruction and a univentricular heart were both significantly more frequent in association with right compared with left isomerism. Significant differences were also noted in the two groups in terms of ventriculoarterial connections and infundibular morphology.
我们分析了43例心房异构心脏的房室交界、心室质量和心室动脉交界。这些心脏中，32例心房具有双侧右房形态，11例心房具有双侧左房特征。在右房异构的心脏中，有13例双心室心脏，均伴有模糊的房室连接。8例有共同瓣膜，5例有两个房室瓣。在另外19例心脏中，心房仅与一个心室相连，18例通过共同瓣膜有双入口心室，另一例无左房室连接。在这些单心室心脏中，发现了所有可能类型的心室形态。这些右异构心脏的心室动脉交界表现出很大差异。在左房异构的心脏中，9例有两个心室，2例为单心室。双心室心脏均有模糊的房室连接，6例通过共同瓣膜，3例通过两个瓣膜。这两个单心室心脏均通过共同瓣膜有双入口，一个通向右心室型腔室，另一个通向左心室型腔室。两者均有互补型的残腔。心室动脉交界再次表现出很大差异。统计分析表明，与左异构相比，右异构合并肺动脉梗阻和单心室心脏的情况明显更常见。两组在心室动脉连接和漏斗部形态方面也存在显著差异。
