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.