The Clinical Analysis For70Cases With Dextrocardia

Objective： To investigate the etiology, clinical manifestation,complication, examination, treatment and prognosis of dextrocardia. Inorder to explore the early intervention of dextrocardia, then improve thesurvival rate and quality of life.Methods: Analyze70cases of dextrocardia between February1993and January2013from Children’s Hospital of Chongqing MedicalUniversity with the retrospective method．Results:1. Of total70cases, the age of initial diagnosis was from0day to16year old(median age is5mouths),68.6%initial diagnosed in infant period.There were40boys and30girls, sex ratio is1.33:1. There were44patients(62.9%) in the city and26patients (37.1%) in the countryside.2. There were26cases(37.1%) of mirror image dextrocardia,29cases(41.5%） of dextroversion and15cases (21.4%) of cardiacdextroposition.3.The major signs were point of maximal impulse in right chest(100%),cyanosis(27.1%), polypnea(41.4%), murmurs(40%) and stunted growth(27.1%). There were4cases(5.7%) in dextrocardia without anymalformation,18cases(25.7%) in dextrocardia with cardiac malformation,15cases(21.4%) in dextrocardia with cardiac malformation and situsinversus viscerum,10cases(14.3%) in dextrocardia with cardiacmalformation and other malformation,3cases(4.3%) in dextrocardia withcardiac malformation, situs inversus viscerum and other malformation,7cases(10%) in dextrocardia with situs inversus viscerum,10cases(14.3%)in dextrocardia with other malformation,3cases(4.3%) in dextrocardiawith situs inversus viscerum and other malformation.4.The common complication were45cases(64.3%) of pneumonia,9cases(12.9%) of pulmonary hypertension,5cases(7.1%) of cardiac failure.5. There were57cases(81.4%) took chest X-ray,65cases(92.9%) tookEchcardiography,12cases took CT,4cases took cadiac catheterization,26cases took electrocardiogram.6. There were24cases(34.3%) of dextrocardia without cardiacmalformation include1died case.46cases(65.7%) with cardiacmalformation,1case of Percutaneous transcatheter closure of ventricularseptal defect.13cases of surgical therapy include2died case.32caseswithout surgical therapy include5died cases and15cases gave up.7. The abnormalities of gestation:21cases(30%) infected in earlygestation,7cases(10%) used medicine,6cases(8.6%) were elder pregnantwomen(>35years). The past history of parents:4cases(5.7%) had spontaneous abortion or dead fetus history,3cases(4.3%) of father withchronic diseases.Conclusion:1. Dextrocardia has varied clinical manifestations, include maximalimpulse in right chest, murmurs, cyanosis, and polypnea, growthretardation.2. Dextrocardia often combine cardiac malformation.The most commoncomlplication is pneumonia.3. Echocardiography is the preferred method in the diagnosis, followingup and assessing cardiac function of dextrocardia and cardiac defect.4. Dextrocardia with congenital malformation need surgical therapy orinterventional therapy.5. The major risk factor is infection in early gestation.