Abstract
The purpose of this study was to report 18 cases of criss-cross heart and to evaluate the utility of magnetic resonance imaging (MRI) for the determination of atrioventricular segmental situs and atrioventricular alignment in patients with criss-cross heart. From August 1999 to March 2007, 18 consecutive patients with criss-cross heart were studied using a 1.5T MR scanner. Echocardiography and x-ray angiocardiography were performed in all patients and surgery was performed in 12 patients. MR examination resulted in the same diagnosis with x-ray angiocardiography in 94.4% of patients (17 of 18). The visceroatrial situs was solitus in 17 patients with normal left side heart position in 14 and dextrocardia in 3. The visceroatrial situs was inversus in 1 patient with dextrocardia. The atrioventricular connections were concordant in 17 patients and discordant in 1. In all patients, the right ventricle was located superiorly and the left ventricle inferiorly. Criss-cross heart is a rare malformation caused by abnormal rotation of ventricles in the embryo. Diagnosis of criss-cross heart is difficult and MRI was very helpful. MRI allowed clear visualization of the horizontal ventricular septum, the crossing inflow streams, atrioventricular segmental situs, atrioventricular alignment, and other malformations.
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References
Anderson RH (1982) Criss-cross hearts revisited. Pediatr Cardiol 3:305–313
Anderson RH, Smith A, Wilkinson JL (1987) Disharmony between atrioventricular connections and segmental combinations: unusual variants of “crisscross” hearts. J Am Coll Cardiol 10:1274–1277
Araoz PA, Gautham RP, Thomson PD, Higgins CB (2002) Magnetic resonance angiography of criss-cross heart. Circulation 105:537–538
Cantinotti M, Bell A, Hegde S, Razavi R (2007) A segmental approach to criss-cross heart by cardiac MRI. Int J Cardiol 118:e103–e105
Duncan WJ, Wong KK, Freedom RM (2006) A criss-cross heart with twisted atrioventricular connections, “perfect streaming,” and double discordance. Pediatr Cardiol 27:604–607
Geva T, Sanders SP, Ayres NA, O’Laughlin MP, Parness IA (1993) Two-dimensional echocardiographic anatomy of atrioventricular alignment discordance with situs concordance. Am Heart J 125:459–464
Link KM, Weesner KM, Formanek AG (1989) MR imaging of the criss-cross heart. AJR 152:809–812
Marino B, Mileto F (2002) Criss-cross heart with D-ventricular Loop. Circulation 106:e223–223
Marino B, Sanders SP, Pasquini L, Giannico S, Pamess IA, Colan SD (1986) Two-dimensional echocardiographic anatomy of crisscross heart. Am J Cardiol 58:325–333
Ming Z, Yuming Z, Yuhua L, Biao J, Aimin S, Qian W (2006) Diagnosis of congenital obstructive aortic arch anomalies in Chinese children by contrast-enhanced magnetic resonance angiography. JCMR 8:747–753
Nielsen JC, Parness IA (2002) Anatomy of a criss-cross heart. Circulation 106:e41–41
Podzolkov VP, Ivanitsky AV, Makhachev OA, Alekian BG, Chiaureli MR, Raqimov FR (1990) Fontan-type operation for correcting complex congenital defects in criss-cross heart. Pediatr Cardiol 11:105–110
Van Praagh R, Weinberg PM, Matsuoka R, Van Praagh S (1983) Malpositions of the heart. In: Adams FH, Emmanouilides GC (eds) Moss’ heart disease in infants, children, and adolescents. Williams & Wilkins, Baltimore, pp 422–458
Van Praagh S, La Corte M, Fellows KE, Bossina K, Busch HJ (1980) Supero-inferior ventricles: anatomic and angiocardiographic findings in 10 postmortem cases. In: Van Praagh R, Takao A (eds) Etiology and morphogenesis of congenital heart disease. Futura, Mount Kisco, NY, pp 317–378
Weber OM, Higgins CB (2006) MR evaluation of cardiovascular physiology in congenital heart disease: flow and function. JCMR 8:607–617
Yoo SJ, Seo JW, Lim TH, Park IS, Hong CY, Song MG, Kim SY, Choe KO, Cho BK, Lee HJ (1993) Hearts with twisted atrioventricular connections: findings at MR imaging. Radiology 188:109–113
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Ming, Z., Yumin, Z. Magnetic Resonance Evaluation of Criss-Cross Heart. Pediatr Cardiol 29, 359–365 (2008). https://doi.org/10.1007/s00246-007-9069-z
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DOI: https://doi.org/10.1007/s00246-007-9069-z