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The three types of criss-cross heart: a simple rotational anomaly
Insights
Criss-cross heart, a complex congenital heart defect, involves apparent contrast crossing without mixing at the atrioventricular level. Understanding ventricular rotation clarifies this malformation, with clockwise rotation in normal and complete transposition hearts and counter-clockwise in corrected transposition.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Pediatric Cardiology
Background:
- Criss-cross heart is an angiographically complex congenital heart malformation.
- It is characterized by apparent crossing of the atrioventricular pathways without contrast medium mixing.
- Understanding the underlying ventricular rotation is key to diagnosing this condition.
Observation:
- Ventricular rotation can be clockwise or counter-clockwise.
- Normal hearts and those with complete transposition exhibit clockwise rotation.
- Corrected transposition is associated with counter-clockwise ventricular rotation.
Findings:
- This report details one case of criss-cross heart associated with corrected transposition.
- Two additional cases of criss-cross heart occurring with complete transposition are also presented.
- These cases highlight the varied presentations of criss-cross heart in conjunction with other transposition types.
Implications:
- Clarifying the relationship between ventricular rotation and criss-cross heart aids in diagnosis.
- Understanding these associations improves the management of complex congenital heart disease.
- Further research into these malformations can enhance surgical and therapeutic strategies.
Abstract:
Criss-cross heart is an angiographically confusing malformation where apparent crossing but not mixing of contrast medium is seen at atrioventricular level. The malformation can be understood by a clockwise or counter-clockwise ventricular rotation. In the normal heart or one with complete transposition ventricular rotation is clockwise. With corrected transposition rotation occurs in a counter-clockwise fashion. One case of criss-cross heart with associated corrected transposition and two criss-cross hearts occurring with complete transposition are reported.