EP06.28: Prenatal diagnosis and outcome of meso/dextrocardio: a single‐centre report of 29 cases

Meso/dextrocardia, which is a cardiac axis abnormality, is associated with various complications and has a poor prognosis. However, there are few reports about fetal meso/dextrocardia. In this study, we reviewed cases of fetal meso/dextrocardia diagnosed in our hospital. 29 fetal meso/dextrocardias were diagnosed between January 2014 and February 2024. Mesocardia was diagnosed as the heart which was in the middle of the thorax with the cardiac axis pointing to the mid-chest, and dextrocardia was diagnosed as the heart which was in the right chest. Dextrocardia was classified into two types; dextroposition was diagnosed as dextrocardia with the cardiac axis pointing to the middle or left chest, and dextroversion was diagnosed as dextrocardia with the cardiac axis was pointing to the right. Eight mesocardias and 21 dextrocardias (17 dextropositions and four dextroversions) were diagnosed out of 29 cases. Mesocardia included three right lung hypoplasia cases (3q trisomy, esophageal bronchopleural fistula, and left pulmonary artery sling) and five persistent left superior vena cava (PLSVC) cases (two isolated PLSVC, one VACTERL association, and two 13 trisomy cases). Dextroposition included congenital pulmonary airway malformation in seven cases, left pulmonary sequestration in one case, congenital diaphragmatic hernia in six cases, right lung hypoplasia in one case, and one VACTERL association with right lung aplasia and esophageal atresia. Dextroversion included two asplenia syndrome cases, one single ventricle case, and one Temple syndrome with PLSVC and bilateral pulmonary artery hypoplasia case. In this study, we reviewed fetal meso/dextrocardia. Although some cases had good prognosis such as PLSVC alone cases, there were some cases with adverse complications which should be managed strictly in perinatal period. When fetal meso/dextrocardia is detected, it is important to evaluate fetal whole body anomaly, not only heart and lungs.