title: Prenatal diagnosis of criss-cross heart: sonographical and pathological features of five cases.
abstract: OBJECTIVE
  To describe the sonographical and pathological features of fetal criss-cross heart (CCH).
  
  
  METHODS
  All cases of fetal CCH diagnosed by fetal echocardiogram from May 2003-May 2011 were identified at a single referral center using an established perinatal database. Demographic and genetic information, sonographical images and autopsy reports were reviewed. Sonographical and pathological features are described.
  
  
  RESULTS
  Five cases of fetal CCH were identified, all of which were confirmed by autopsy. Characteristic sonographical findings include: (1) the inability to obtain four-chamber view at standard transverse plane through the fetal chest; (2) appreciation of the misaligned spatial atrial-ventricle connection with the interventricular septum in a 'spiraling' orientation; (3) orientation of the two ventricular inlets in a superior-inferior and crossing position; and (4) a four-chamber-like view seen in the sagittal plane of the fetal chest. Doppler ultrasound demonstrates the 'criss-cross' arrangement of the inflow tracts into the two ventricles simultaneously in the transverse plane of the fetal chest.
  
  
  CONCLUSIONS
  CCH is a rare developmental disorder that can be accurately diagnosed prenatally. Early diagnosis will allow for more targeted counseling and early intervention.
authors.affiliation: Department of Ultrasound, Shenzhen Maternity and Child Healthcare Hospital, Affiliated to Southern Medical University, Shenzhen, China. lishengli63@126.com
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: G
authors.initials: G
authors.lastname: Luo
authors.forename: E R
authors.initials: ER
authors.lastname: Norwitz
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: S
authors.initials: S
authors.lastname: Ouyang
authors.forename: Y
authors.initials: Y
authors.lastname: Yao
authors.forename: H
authors.initials: H
authors.lastname: Wen
authors.forename: C
authors.initials: C
authors.lastname: Chen
authors.forename: Q
authors.initials: Q
authors.lastname: Fu
authors.forename: X
authors.initials: X
authors.lastname: Xia
authors.forename: J
authors.initials: J
authors.lastname: Bi
authors.forename: J
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000328:Adult; D001344:Autopsy; D003376:Counseling; D003420:Crisscross Heart / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology*; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D012189:Retrospective Studies; D012494:Sampling Studies; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult