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Criss-cross heart--a case with horizontal septum, complete transposition, pulmonary atresia and ventricular septal
Insights
Criss-cross heart, a rare anomaly, involves crossing blood streams at the atrioventricular level without mixing. This case presents a unique combination of cardiac defects, including d-transposition of the great arteries and pulmonary atresia.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Criss-cross heart is a rare congenital anomaly characterized by the crossing of systemic and pulmonary blood streams at the atrioventricular (AV) level without intracardiac mixing.
- Understanding the anatomical variations and associated defects is crucial for diagnosis and management.
Observation:
- A case of criss-cross heart is presented with a solitus right atrium connected to a left-superior, morphologically right ventricle.
- The left atrium was connected to a normally positioned, morphologically left ventricle, with the interventricular septum in a horizontal plane.
- Associated anomalies included complete d-transposition of the great arteries with l-positioned aorta, pulmonary atresia, ventricular septal defect, atrial septal defect, and patent ductus arteriosus.
Findings:
- This report provides the first angiocardiographic demonstration of this rare combination of congenital heart defects.
- The study reviews existing literature on criss-cross heart and horizontal interventricular septum.
- The findings emphasize the recognition of criss-cross heart as an established angiocardiographic entity.
Implications:
- This detailed case report contributes to the understanding of complex congenital heart anomalies.
- Accurate angiocardiographic recognition of criss-cross heart is vital for appropriate clinical management and surgical planning.
- Further research into the embryological basis and long-term outcomes of criss-cross heart is warranted.
Abstract:
Criss-cross heart is a recently described anomaly in which the systemic and pulmonary blood streams cross at the atrioventricular (AV) level, without mixing. A case of criss-cross heart is described in which the right atrium, in a solitus position, communicated with a left-superior positioned, morphologically right ventricle, and the left atrium communicated with a normally located, morphologically left ventricle. The interventricular septum occupied a horizontal plane. Associated defects were complete d-transposition of the great arteries with l-positioned aorta, pulmonary atresia, ventricular septal defect, atrial septal defect, and patent ductus arteriosus. To the best of our knowledge this is the first angiocardiographic demonstration of this rare combination of lesions. The literature on criss-cross heart and horizontal septum is reviewed. It is stressed that regardless of whether the criss-cross phenomenon is an anatomical fact or an angiocardiographic illusion, it is an established angiocardiographic entity and should be recognized as such.