Methods
We identified publications than might relate to the presence of
isomerism in the setting of so-called “visceral heterotaxy”. From
these publications, we collated and analyzed the anatomical descriptions
of the systemic and pulmonary venous connections, and the presence of
associated cardiac and non-cardiac anomalies, paying special attention
to surgical and non-surgical treatments used and their outcomes. The
search engines employed were PubMed, Google Scholar, Cochrane Database
for Systematic Reviews, Cochrane Central Register of Controlled Trials,
Ovid Medline, ACP Journal Club, Ovid EMBASE, and Database of Abstracts
of Review of Effectiveness in all languages. We made an individualized
review of 62 investigations,1-23,26-64 incorporating
these findings with the results of US Scientific Registry of Transplant
Recipients Data, along with results emanating from Loma Linda
University.24,25 Due to limited sample sizes, the
heterogeneity of clinical state at the time of surgical intervention,
inclusion of necropsy data, and the difficulties in selection of
appropriate cardiac quantifiable end points, it did not prove possible
to perform a meta-analysis.