Isolated levocardia: prenatal diagnosis, clinical importance, and literature review

Area of Science:

• Medical imaging and diagnostics
• Fetal medicine
• Congenital abnormalities

Background:

• Isolated levocardia is a rare congenital condition characterized by a normally positioned heart (levocardia) with dextroposition of abdominal viscera.
• Prenatal diagnosis and management strategies for isolated levocardia are not well-established.
• This study focuses on the prenatal diagnosis and postnatal outcomes of fetuses diagnosed with isolated levocardia.

Observation:

• Three cases of isolated levocardia were identified and evaluated at a tertiary ultrasound unit.
• Fetal assessments were conducted every four weeks until delivery and continued postnatally.
• Associated anomalies, including interruption of the inferior vena cava with azygos continuation, polysplenia, asplenia, and a small ventricular septal defect, were noted.

Findings:

• Prenatal diagnosis of isolated levocardia was achieved through detailed ultrasound evaluations.
• Postnatal evaluations confirmed varying degrees of splenic anomalies (polysplenia and asplenia) in neonates.
• A small ventricular septal defect was identified in one neonate.

Implications:

• Isolated levocardia, particularly when other malformations are absent, appears to have a favorable outcome.
• Conservative management is suggested for isolated levocardia in the absence of significant associated anomalies.
• Early prenatal diagnosis facilitates appropriate planning for postnatal care and management.