The ester functionality does not introduce a center of asymmetry and thus optical and geometric isomerism does not result from the presence of this functional group. The ester functionality (the carbonyl and ether oxygen) is composed of an sp hybridized carbon so it cannot be chiral, and since there is free rotation about the ether bond geometric isomerism also is not possible at the sp center....

There are reports that in right atrial isomerism the conduction system has paired sinus nodes and paired atrioventricular nodes. Electrophysiological studies were performed in two patients with right atrial isomerism. One patient had a delta wave on the surface electrocardiogram without tachycardia attacks. The other, who did not have manifest pre-excitation, had recurrent narrow QRS tachycardi...

Reversible encapsulation complexes create spaces where two or more molecules can be temporarily isolated. When the mobility of encapsulated molecules is restricted, different arrangements in space are possible, and new forms of isomerism ("social isomerism") are created: the orientation of one encapsulated molecule influences that of the other in the confined space. Expansion of a capsule's len...

Objective: Totally anomalous pulmonary venous connection directly to the superior caval vein is unusual. It is frequently associated with major congenital heart defects such as the syndrome of right isomerism. While improved results have been reported recently for the isolated form, complex cases are still associated with a higher mortality. Methods: We undertook surgical correction in nine pat...

Congenital cardiac malformations which include isomerism of the atrial appendages are amongst the most challenging of problems for diagnosis and also for medical and surgical management. The nomenclature for pathological description is controversial, but difficulties can be overcome by the use of a segmental approach. Such an approach sets out the morphology and the topology of the chambers of ...

We have analysed the atrioventricular junction, ventricular mass, and ventriculoarterial junction in 43 hearts with isomeric atrial chambers. Of the hearts, 32 had atrial chambers of bilateral right morphology while 11 had atrial chambers with bilateral left atrial characteristics. Among the hearts with right atrial isomerism, there were 13 biventricular hearts, all with ambiguous atrioventricu...

The anatomy of a persistent left superior vena cava (SVC) to the left atrium (LA) without the innominate vein can make it challenging to complete intracardiac repair. We reviewed our five cases of the direct end-to-side anastomosis of SVCs to facilitate anatomical repair of SVC-right atrial connection for biventricular repair. Diagnoses were two partial atrioventricular septal defect with left ...

Chemists have long been intrigued by the molecular basis of isomerism. Indeed, much of the powerful paradigm of structure based upon the molecular graph was first invented to explain isomerism, including the classifications used in modern stereochemistry. Thus, constitutional isomers describe pairs of isomeric molecular structures possessing non-homeomorphic molecular graphs, while the classica...

OBJECTIVE Fontan completion in patients with atrial isomerism, in which the inferior vena cava (IVC) and the hepatic vein (HV) drain separately, is technically challenging. Herein, we review our surgical approach to these patients. METHODS The medical records of 50 consecutive patients with atrial isomerism who underwent Fontan completion between 1998 and 2008 were reviewed retrospectively. ...

Introduction Bodily isomerism, also known as heterotaxy, is a unique entity in which there is mirror imagery in various organ systems. Those with isomerism will often have congenital malformations of the heart requiring functionally univentricular palliation. Anecdotally, thrombocytosis has been noted with higher frequency in patients with isomerism. This study aimed to determine the prevalence...