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Criss-cross heart with straddling right atrioventricular valve
Insights
This case study presents a rare criss-cross heart anomaly with straddling tricuspid valve. Combined imaging techniques like angiography and echocardiography are crucial for diagnosing complex congenital heart defects.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Criss-cross heart, a rare congenital anomaly, involves abnormal spatial arrangement of ventricles.
- Straddling tricuspid valve is a complex defect where the valve annulus is displaced over the ventricular septum.
Observation:
- A case of criss-cross heart with normal atrial situs and a straddling tricuspid valve was analyzed.
- The morphological right ventricle was superior and left, connected to the right atrium, while the left ventricle was inferior and right, connected to the left atrium.
- Both great arteries originated from the right ventricle, with the aorta anteriorly positioned.
Findings:
- The condition was diagnosed as criss-cross heart with a concordant atrioventricular (A-V) connection and double outlet right ventricle (DORV).
- Two-dimensional (2-D) echocardiography initially identified the straddling right A-V valve, which was confirmed by right atrial angiography.
Implications:
- This highlights the importance of advanced imaging in diagnosing complex cardiac malformations.
- Integrated diagnostic approaches using echocardiography and angiography are vital for accurate characterization and management of such anomalies.
Abstract:
Angiocardiographic appearance of a criss-cross heart with straddling tricuspid valve has been presented. Atrial situs was normal and the right atrium was connected to the morphological right ventricle situated superiorly and to the left of the left ventricle. The left atrium was connected to the morphological left ventricle situated inferiorly and to the right of the right ventricle. The interventricular septum was horizontal in position. Both great arteries arose from the right ventricle with the anterior aorta. The case was concluded as a criss-cross heart with concordant atrioventricular (A-V) connection and double outlet right ventricle (DORV). Straddling of the right A-V valve was recognized in another institution by two-dimensional (2-D) echocardiography and confirmed by right atrial angiography in our institution. The value of combined investigation with selective four-chamber angiography, especially including right atrial angiography and 2-D echocardiography in the diagnosis of such complex cardiac anomalies has been stressed.