Reported mortalities extend to 85% for those with right, and 50% for those with left isomerism. Atrioventricular septal defect is reported in up to four-fifths, more frequently in right isomerism, with such patients typically having discordant ventriculoatrial connections or double outlet right ventricle. Univentricular atrioventricular connections are expected in up to three-quarters of those with right isomerism. The coronary sinus is universally absent in right isomerism, along with totally anomalous pulmonary venous connection, and is absent in two-fifths of those with left isomerism. Azygos extension of the inferior caval vein is reported in three-quarters of those with left isomerism. Results: Half of patients with right isomerism, and two-thirds of those with left isomerism have bilateral superior caval veins. Methods: We reviewed pertinent published studies on surgical treatment of individuals with isomeric atrial appendages, with the pertinent surgical details provided by most of the manuscripts. Background and aim: On the basis of previously published accounts, coupled with our own experience, we have assessed the surgical approaches to patients with isomeric atrial appendages.
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