Persistent right umbilical vein in isomerism

Abstract

Objective Our objective was to evaluate the incidence of a persistent right umbilical vein in isomerism versus situs solitus. Methods For this retrospective, observational, nonrandomized report, we identified fetuses with confirmed right umbilical veins from all patients referred for fetal echocardiography in Southern Nevada between January 2006 and January 2019. Results For the period January 2006 to January 2019, we identified 89 fetuses with situs solitus and a right umbilical vein from 16 320 women undergoing prenatal cardiac evaluation, resulting in a right umbilical vein incidence of 0.5% in situs solitus. For the same period, we identified 36 fetuses with isomerism and confirmatory umbilical vein imaging. Of the 36, 15 (42%) had right umbilical veins. Of the 15, four of 11 (19%) had left isomerism, and 11 of 15 (73%) had right isomerism (P = .006). Conclusions A right umbilical vein is rare with situs solitus and common with isomerism. A right umbilical vein is more common in right isomerism than left isomerism and should alert the clinician to check for isomeric situs, especially right isomerism.

Cardiac Laterality: Surgical Results of Right Atrial Isomerism

“…However, in our center, the 38 patients included in this study were diagnosed in the preoperative stage with the support of auxiliary diagnostic methods. The initial evaluation in the neonatal stage is fundamental, as well as early postnatal care [33], due to the fact that the persistence of the right umbilical vein has recently been identified in 42% of cases of AI in the fetal period, predominantly in RAI, with 73% [34], and should include the coordinated actions of teams with different specialties, not only pediatric cardiology and pediatric cardiac surgery.…”

Atrial isomerism: A multidisciplinary perspective

“…Echocardiogram is the main initial diagnostic method 13 , both at prenatal and postnatal stages, due to the accuracy, it can have with regard to anatomical images. Recently, the right umbilical vein persistence in the fetal stage was identified in 42% of cases with isomorphism, with this phenomenon being predominant in dextromorphism, with 73% 14 . At postnatal stage, the right or left isomorphism is diagnosed by inferior vena cava and abdominal aorta abnormal position, in addition to multiple associations with other heart defects 1,6,8 (Table 1).…”

Isomorfismo cardiaco: Una perspectiva multidisciplinaria

“…El ecocardiograma constituye el principal método diagnóstico inicial 13 , tanto en la etapa prenatal como en la posnatal, debido a la precisión que puede tener en relación con las imágenes anatómicas. Recientemente se identificó en la etapa fetal persistencia de la vena umbilical derecha en el 42% de casos con isomorfismo, predominando en el dextromorfismo con un 73% 14 . En la etapa posnatal el isomorfismo derecho o izquierdo se diagnostica por la posición anormal de la vena cava inferior y la aorta abdominal, además de múltiples asociaciones con otros defectos cardiacos 1 , 6 , 8 ( Tabla 1 ).…”