J Med Ultrason (2001)

. 2025 Oct 25.

 doi: 10.1007/s10396-025-01583-8. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/41137976/

Prenatal diagnosis and outcome of meso/dextrocardia: a single-center report of 29 cases

Yuya Tanaka ¹, Yoshifumi Kasuga ², Keisuke Akita ¹, Yuka Fukuma ¹, Junko Tamai ¹, Keita Hasegawa ¹, Satoru Ikenoue ¹, Daigo Ochiai ^1 3, Mamoru Tanaka ¹

Affiliations Expand

• PMID: 41137976
• DOI: 10.1007/s10396-025-01583-8

Abstract

Purpose: While meso/dextrocardia, a cardiac axis abnormality, is associated with various complications and a poor prognosis, few studies have been reported. We aimed to identify and review patients at our hospital who had been diagnosed with fetal meso/dextrocardia.

Methods: The medical records of 29 patients diagnosed with fetal meso/dextrocardia between April 1, 2014 and March 31, 2024 were reviewed.

Results: We identified eight cases of mesocardia and 21 cases of dextrocardia (17 dextropositions and four dextroversions). Right lung hypoplasia (including 3q trisomy, esophageal bronchopleural fistula, and left pulmonary artery sling) was identified in three cases. Five cases of persistent left superior vena cava (PLSVC) were identified [isolated PLSVC (n = 2), VACTERL association (n = 1), trisomy 13 (n = 2)]. Dextroposition was linked to congenital pulmonary airway malformation (eight cases), left pulmonary sequestration (one case), congenital diaphragmatic hernia (six cases), right lung hypoplasia (one case), and VACTERL association with right lung aplasia and esophageal atresia (one case). Dextroversion was associated with asplenia syndrome (two cases), single-ventricle (one case), and Temple syndrome with PLSVC and bilateral hypoplastic pulmonary arteries (one case). Among 29 newborns, six (20.7%) died during the early neonatal period and seven (24.1%) required postnatal multidisciplinary treatment, highlighting a poor prognosis in many cases.

Conclusion: While some patients, such as those with isolated PLSVC, had favorable outcomes, several cases involved severe complications requiring intensive perinatal management. When fetal meso/dextrocardia is detected, it is critical to evaluate fetal anomalies comprehensively and not limit assessment to the heart and lungs.

Keywords: Congenital; Dextrocardia; Heart defects; Persistent left superior vena cava; Pulmonary hypoplasia; Trisomy.

© 2025. The Author(s), under exclusive licence to The Japan Society of Ultrasonics in Medicine.