Surgical implications in hearts with isomeric atrial appendages.

As we have tried to demonstrate in this chapter, extensive understanding of morphology is necessary for successful definitive repair in individual patients with isomeric atrial appendages, as well as for the further evolution of optimal surgical strategies. Obviously different from patients with the usual atrial arrangement, those with isomeric atrial appendages have specific morphologic features that may underscore the clinical problems frequently found in this setting. Surgical strategies as well as individual operative procedures should be established on the basis of knowledge regarding those features presently demonstrated, namely, ventricular structures, the atrioventricular valves, the coronary circulation, and so on. Further investigations will certainly provide other aspects of which we are at present unaware.