Unique types of criss-cross heart.
Three cases of criss-cross heart which we have observed during last five years are described. All of these cases were diagnosed by angiocardiography and two-dimensional echocardiography, and one of them was verified by autopsy. Two of them are unique among cases reported thus far. Case 1 shows ordinary criss-crossing with supero-inferior ventricle, and case 2, extreme crossing atrioventricular (A-V) valves, in which the right-sided right atrium connects to the left posteriorly positioned right ventricle through the tricuspid valve, and the left-sided left atrium to the right anterior left ventricle via a posteriorly positioned mitral valve. In case 3, the criss-cross appearance is secondary to displacement of the heart by compression caused by a diaphragmatic hernia. Findings in these cases suggest that criss-cross heart is caused not only by primary rotation of the ventricles during cardiac morphogenesis but also by secondary rotation of a formed heart induced by extracardiac compression. The degree of rotation in these cases revealed a wide spectrum from minimal to extreme. In addition, subxiphoid two-dimensional contrast echocardiography is recommended as the only accurate method of non-invasive diagnosis of this condition.
D000790:Angiocardiography; D001011:Aorta / Q000002:abnormalities; D004374:Ductus Arteriosus, Patent / Q000150:complications; D004452:Echocardiography / Q000379:methods; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000473:pathology; D006344:Heart Septal Defects, Atrial / Q000150:complications; D006345:Heart Septal Defects, Ventricular / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D014188:Transposition of Great Vessels / Q000150:complications; D014683:Vena Cava, Superior / Q000002:abnormalities