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Multimodality cardiac imaging for pre-operative evaluation in a paediatric criss-cross heart patient: a case report
Kwannapas Saengsin1, Surin Woragidpoonpol2, Tanop Srisuwan3
1Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Road, Sri Phum Subdistrict, Mueang Chiang Mai District, Chiang Mai 50200, Thailand.
Insights
Criss-cross heart (CCH) is a rare congenital heart disease. Multimodality imaging aids in diagnosing and successfully treating complex CCH cases.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Criss-cross heart (CCH) is an exceptionally rare and complex congenital heart disease (CHD).
- CCH is characterized by a twisted atrioventricular connection and crossing inflow streams to the ventricles.
- Accurate diagnosis and treatment planning for CCH are challenging due to its anatomical complexity.
Observation:
- A one-year-old female presented with cyanosis and abnormal heart sounds.
- The patient had a complex congenital CCH requiring surgical intervention.
- Diagnosis and surgical planning were facilitated by advanced imaging techniques.
Findings:
- Successful biventricular repair was achieved in a patient with complex CCH.
- Multimodality cardiac imaging, including echocardiography, CT, 3D printing, and 4D flow-CMR, was crucial.
- This approach enabled precise anatomical assessment and guided the surgical strategy.
Implications:
- Multimodality cardiac imaging is essential for managing complex congenital heart diseases like CCH.
- Advanced imaging techniques improve diagnostic accuracy and surgical outcomes in rare CHD.
- This case highlights the importance of integrated imaging for complex pediatric cardiac conditions.
Background:
Criss-cross heart (CCH) is considered as one of the most complex, challenging, and exceptionally rare congenital heart diseases (CHDs). Criss-cross heart is defined by the twisted atrioventricular connection and the crossing of inflow streams to both ventricles, caused by the rotation of the ventricular mass along its longitudinal axis. The treatment depends on the anatomical complexity. Diagnosis of CCH is difficult, and interpretation of imaging results may be challenging.
Case Summary:
A one-year-old girl presented with cyanosis and abnormal heart sounds. We report a patient with complex congenital CCH who underwent successful biventricular repair using multimodality cardiac imaging, including echocardiography, cardiac computerized tomography, 3D printing, and 4D flow-CMR (cardiac magnetic resonance).
Discussion:
Criss-cross heart is one of the most complex and rare CHD. Multimodality cardiac imaging is essential for finding the answers and providing better care for complex CHD patients.
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