January 2011 ORIGINAL ARTICLES

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Cabanela RL. Validity of the Revised Impact on Family (IOF) Scale. J Pe-

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21. Cohen JA. power primer. Psychol Bull 1992;112:155-9.

22. Kazak AE, Kassam-Adams N, Schneider S, Zelikovsky N, Alderfer M,

Rourke MT. An integrative model of pediatric medical traumatic stress.

J Pediatr Psychol 2006;31:343-55.

23. Sprangers MAG, Schwartz CE. Integrating response shift into health-related

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24. Schnurr PP, Hayes AF, Lunney CA, McFall M, Uddo M. Longitudinal

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50 Years Ago in THE JOURNAL OF PEDIATRICS

Predictors of Parental Quality of Life after Child Open Heart Surg

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25. Bronner MB, Knoester H, Bos AP, Last BF, Grootenhuis MA. Follow-up

after paediatric intensive care treatment: parental posttraumatic stress.

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26. Goldbeck L, Melches J. The impact of the severity of disease and social

disadvantage on quality of life in families with congenital cardiac disease.

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27. Hatzmann J, Heymans HSA, Ferrer-i-Carbonell A, van Praag BMS,

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Congenital Dextrocardia: Clinical, Angiographic, and Autopsy Studies on 50 PatientsArcilla RA, Gasul B. J Pediatr 1961;58:39-58, 251-62

Arising from the complex interplay of several potential etiologic factors (thoracic abnormalities, situs inversus, het-erotaxy syndromes, and interactions among lung and cardiac development), with a clinical impact ranging from

minimal to lethal, and with teasing linkages to cardiac embryology, dextrocardia stimulates endless medical conver-sation. Despite their use of research techniques (diagnostic angiography, chest x-ray, and electrocardiography) anda presentation style (clinical case series without a single statistical comparison) completely out of fashion today, Arcillaand Gasul demonstrate the best thinking in pediatric cardiology. Ben Gasul was a founding father of pediatric cardi-ology in Chicago, authoring one of the first comprehensive pediatric cardiology textbooks, and Rene Arcilla was ar-guably his most important disciple, developing clinical programs at the University of Chicago and Hope Children’sHospital and improving the lives of thousands of children with heart disease. Contemporary with this article’s pub-lication, Maurice Lev was providing dramatic new insight into congenital heart disease pathology at the University ofChicago; Milton Paul was moving to Children’s Memorial Hospital in Chicago, where he and his colleagues, includingAlex Muster, were to make critical cardiac catheterization observations integrating anatomic findings with cardiacphysiology; and the Van Praaghs briefly became Chicagoans, studying cardiac pathology before returning to Bostonand founding their own pioneering laboratory.

Circa 1960, this article provides a state-of-the-art description of how to clinically assess a patient with dextrocardia,combining a new technique, diagnostic angiography, with traditional resources of radiography, electrocardiography,and autopsy. A complete evaluation of dextrocardia can be performed by referring to the precise textual description,the remarkable 17 figures, and the 4 tables (2 of which contain individual information on all 50 patients) presented.Although the novel 5-component classification of dextrocardia described was soon to be usurped by the understand-ing of heterotaxy syndromes, scimitar syndrome, and cardiac development (often in research pioneered by this uniquecongregation of cardiac anatomists then in Chicago), the painstaking associative methodology used in this descriptivestudy is a wonderful example of the research foundation for early advances in pediatric cardiology. Over the next 20years, with the development of cardiac surgery, the case series, associating clinical and pathologic findings with surgicaloutcomes, laid the foundation for the field as it exists today.

Samuel S. Gidding, MDNemours Cardiac Center

A.I. duPont Hospital for ChildrenWilmington, Delaware

10.1016/j.jpeds.2010.08.018

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