Cardiologia Clínica e Experimental
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A Rare Association of Double Outlet Rightventricle with Non-Committed Interventricular Communication, Aberrant Right Subclavian Artery, Persistent Left Superiorvena Cava and Tracheoesophageal Fistula in a Newborn

Elio Caruso*, Silvia Farruggio

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Dextrocardia is an abnormal situs which occurs when the apex of the heart points to the right and inferiorly.
  Dextrocardia could occur in isolation or may occur concomitantly with other cardiac lesions. It could also occur
  with abnormal rotation of the atrium and visceral organs (situs inversus totalis). Complex cardiac anomalies
  coexisting with dextrocardia with certain endocrinepathies are rare occurrence. We report a 2-month-old female who
  presented with breathlessness, cyanosis and subclinical features of congenital hypothyroidism from birth. The child
  was previously managed as neonatal jaundice, but after phototherapy, clinical signs of jaundice persisted. Further
  examination revealed splitting of the second heart sound and a very faint grade 2 ejection systolic murmur located
  at the second left intercostal space. Chest radiograph and echocardiography revealed dextrocardia and transitional
  Atrio-Ventricular (AV) canal defect respectively. He is presently been worked up for AV canal repair and thyroid
  assay result is been waited. Dextrocardia coexisting with AV canal defect and congenital hypothyroidism are rare
  combination of complex cardiac defect. High index of suspicion, timely diagnosis and appropriate referral will help
avert morbidities and mortality associated with this lesion.

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