Related Experiment Video
Updated: Jun 27, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Crisscross hearts in adults: echocardiographic evaluation and natural history
Piotr Hoffman1, Piotr Szymański, Barbara Lubiszewska
1Department of Adult Congenital Heart Disease, Institute of Cardiology, Warsaw, Poland. hoffman@ikard.pl
Insights
Crisscross heart, a rare congenital heart defect, often goes undiagnosed until adulthood. Successful surgical management, tailored to individual hemodynamics, can lead to acceptable functional status in adult patients.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Crisscross heart is a rare congenital abnormality characterized by rotational ventricular malposition.
- Few adult cases of crisscross heart are documented in medical literature.
Observation:
- This case series details 7 adult patients (18-53 years) with crisscross hearts, diagnosed between infancy and 26 years old.
- All patients presented with complex congenital heart defects, including double outlet right ventricle and discordant ventriculoarterial connections.
- Transthoracic echocardiography was the primary diagnostic tool for identifying crisscross heart in all cases.
Findings:
- The clinical outcome in patients with crisscross heart was primarily influenced by underlying hemodynamic issues and surgical results.
- Five patients underwent various surgical interventions, including Rastelli operation, arterial switch, and Glenn anastomosis.
- Successful surgical management enabled acceptable functional status in adulthood for these patients.
Implications:
- This study highlights the importance of recognizing crisscross heart in adults, even with delayed diagnosis.
- Effective surgical strategies can significantly improve the long-term prognosis for adults with this rare condition.
- Further research into the long-term outcomes and management of adult crisscross heart cases is warranted.
Abstract:
Crisscross heart is a rare congenital, rotational abnormality of the ventricular mass, resulting in the crossing of the inflows of the 2 ventricles and each atrium emptying into the contralaterally located ventricle. Few cases of adult patients are described in the literature. We present a case series of 7 adult patients aged 18 to 53 years with crisscross hearts, followed up for 5 to 22 years (mean 14.4 years) at the Institute of Cardiology Warsaw. Only in 2 patients was the diagnosis of crisscross heart made at infancy. In the remaining 5 patients, the diagnosis was made at the age of 7 to 26 years. All patients had complex congenital heart defects, including double outlet right ventricle in 4 patients and discordant ventriculoarterial connections in 3 patients, with numerous associated lesions. In all patients, the diagnosis of crisscross heart was made by transthoracic echocardiographic examination. Five patients underwent surgical procedures, including Rastelli operation, arterial switch, Glenn anastomosis, and central shunt, according to the individual morphology and hemodynamics. The clinical outcome depended predominantly on the underlying hemodynamic abnormalities and the results of surgical management rather than on crisscross anatomy. Successful surgery allowed acceptable functional status in adulthood.
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
01:30Acute Coronary Syndrome III: Diagnostic Studies