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J Thorac Cardiovasc Surg 1994;108:687-691
© 1994 Mosby, Inc.

GENERAL THORACIC SURGERY

What dictates the position of the diaphragm—The heart or the liver?A review of sixty-five cases

Veerappa Reddy, MB, MS, MCh, Sanjeev Sharma, MD, Adnan Cobanoglu, MD


Portland, Ore.

From the Division of Cardiopulmonary Surgery, Oregon Health Sciences University, Portland, Ore.

Received for publication Jan. 27, 1994. Accepted for publication May 31, 1994. Address for reprints: Adnan Cobanoglu, MD, Professor and Chairman, Division of Cardiopulmonary Surgery, Oregon Health Sciences University, L323, 3181 SW Sam Jackson Park Rd., Portland, OR 97201.

Abstract

Case histories of 65 patients with cardiac malposition were reviewed to assess abdominal taxis and hemidiaphragm posture. We present their roentographic findings to support the hypothesis that the cardiac mass determines the caudad displacement and lower position of the related hemidiaphragm. The popular hypothesis that the liver lifts the corresponding hemidiaphragm is questioned. Incidentally, a review of their echocardiographic findings demonstrate the presence of complex congenital heart defects in a majority of these patients. (J THORACCARDIOVASCSURG1994;108:687-91)






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Copyright © 1994 by The American Association for Thoracic Surgery.