RESUMEN
OBJECTIVE: This study aimed to improve the accuracy of prenatal diagnosis by analyzing fetal echocardiographic features of criss-cross heart (CCH), to provide an effective basis for the development of management strategies and improve the prognosis of patients. METHODS: A retrospective analysis was performed on CCH cases diagnosed prenatally at our center between July 2016 and June 2022. Clinical data and prenatal fetal echocardiographic images were reviewed. Literature on prenatal diagnosis of CCH was searched from January 2000 to December 2023 in the PubMed database. RESULTS: Fourteen (0.03%) CCH cases were diagnosed from a database of fetal echocardiograms of 41354 cases at our center. The prenatal genetic testing results were normal in 10 cases and 4 cases didn't check. All cases underwent termination of pregnancy. All cases showed crossed ventricular inflow tracts and combined with other cardiac structural abnormalities. A total of eight articles containing 25 cases were found in the literature review and all cases were associated with other cardiac structural abnormalities. CONCLUSION: Prenatal echocardiography is the primary tool for fetal diagnosis of CCH. Continuous scanning helps avoid missing data and misdiagnosis.
Asunto(s)
Corazón con Ventrículos Entrecruzados , Ecocardiografía , Ultrasonografía Prenatal , Humanos , Femenino , Embarazo , Ultrasonografía Prenatal/métodos , Estudios Retrospectivos , Adulto , Ecocardiografía/métodos , Corazón con Ventrículos Entrecruzados/diagnóstico por imagen , Corazón con Ventrículos Entrecruzados/diagnóstico , Corazón Fetal/diagnóstico por imagenRESUMEN
Crisscross heart (CCH) is a rare anomaly characterized by twisting of the inflow streams of right and left ventricles. The etiology of CCH is not known. Its frequency is less than 8/10, 00,000 live births. Cyanosis is common in neonatal age, while shortness of breath is the main presenting complaint in older children. We present a case series of CCH with array of associations, diagnosed by echocardiography. CCH is a rare heart defect that can be diagnosed by echocardiography by a vigilant operator. Early diagnosis is the key to successful management resulting in increased survival rate, better outcomes and improved quality of life.
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Corazón con Ventrículos Entrecruzados , Cardiopatías Congénitas , Niño , Corazón con Ventrículos Entrecruzados/diagnóstico , Ecocardiografía/métodos , Femenino , Cardiopatías Congénitas/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Recién Nacido , Calidad de VidaRESUMEN
OBJECTIVE: To study the echocardiographic features of criss-cross heart (CCH), a congenital cardiac anomaly characterized by crossed ventricular inflow streams, in Indian patients. METHODS: In this retrospective observational study, all pediatric echocardiograms performed in a single tertiary care institution in South India over a three-year period were scrutinized for a diagnosis of CCH. Demographic, clinical and echocardiographic data were collected from patients' medical records and echocardiographic database. Crossed ventricular inflow streams was identified when there was inability to visualize both atrio-ventricular valves in a single imaging plane in cardiac four chamber view. RESULTS: CCH was diagnosed in five patients from 10,500 pediatric echocardiographic studies. The age at diagnosis ranged from one month to 8 years. Cyanosis was present in all but one of the five cases. Crossed ventricular inflow streams was present by definition in all cases, whereas superior-inferior ventricular relationship was present in only three cases. All cases were associated with ventricular septal defects. Atrio-ventricular discordance was seen in three cases and concordance in two. Ventriculo-arterial discordance was seen in three cases, concordance in one and double outlet right ventricle in one. Three cases had pulmonary stenosis and the other two had pulmonary arterial hypertension. Straddling of AV valve was observed in four cases and hypoplastic aortic arch in one case. CONCLUSION: CCH is an extremely rare congenital cardiac anomaly. Superior-inferior ventricular relationship often co-exists with CCH, but is not necessarily present in all cases. CCH requires early diagnosis because of its common association with diverse cardiac anomalies.
Asunto(s)
Corazón con Ventrículos Entrecruzados/diagnóstico , Ecocardiografía/métodos , Ventrículos Cardíacos/diagnóstico por imagen , Preescolar , Corazón con Ventrículos Entrecruzados/epidemiología , Femenino , Humanos , India/epidemiología , Lactante , Recién Nacido , Masculino , Prevalencia , Estudios RetrospectivosRESUMEN
Crisscross heart is a rare cardiac malformation characterized by crossing of the inflow streams of the two ventricles due to a twisting of the heart about its long axis. The developmental mechanisms and causes of crisscross heart remain unknown. Neonates present with cyanosis and a systolic murmur. In this study, we report a case of crisscross heart with situs inversus, concordant atrioventricular and ventriculo arterial connection with ventricular septal defect and pulmonary stenosis, and review the literature on this rare cardiac malformation.
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Procedimientos Quirúrgicos Cardíacos/métodos , Corazón con Ventrículos Entrecruzados/diagnóstico , Ventrículos Cardíacos/anomalías , Adolescente , Cateterismo Cardíaco , Corazón con Ventrículos Entrecruzados/cirugía , Ecocardiografía , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/cirugía , HumanosRESUMEN
We present the first description of successful radiofrequency (RF) ablation of a bidirectional atrioventricular accessory pathway (AP) guided by nonfluoroscopic mapping with use of three-dimensional magnetic resonance imaging integrated into the Nav-X system (MRI/Nav-X fusion) in a 13-year-old boy with remote surgical palliation for cyanotic criss-cross heart with atrioventricular discordance, double-outlet right ventricle, and a large ventricular septal defect. Due to complex anatomy, a unique finding was that the eliminated left lateral AP electrically connected the left atrium to the antero-superior morphologic right ventricle prior to ablation.
Asunto(s)
Fascículo Atrioventricular Accesorio/cirugía , Mapeo del Potencial de Superficie Corporal/métodos , Ablación por Catéter/métodos , Corazón con Ventrículos Entrecruzados/cirugía , Imagen por Resonancia Magnética/métodos , Cirugía Asistida por Computador/métodos , Fascículo Atrioventricular Accesorio/diagnóstico , Fascículo Atrioventricular Accesorio/etiología , Adolescente , Corazón con Ventrículos Entrecruzados/complicaciones , Corazón con Ventrículos Entrecruzados/diagnóstico , Humanos , Masculino , Imagen Multimodal/métodos , Resultado del TratamientoRESUMEN
El corazón con entrecruzamiento de la circulación venosa pulmonar y sistémica a nivel auriculoventricular, denominada criss-cross, puede coexistir en presencia de situs solitus o situs inversus con concordancia o discordancia aurículo-ventricular dependiendo de la rotación cardíaca sobre el eje longitudinal ventricular, a favor o en contra de las manecillas del reloj. Presentamos el caso clínico de un lactante menor masculino con diagnóstico de corazón en criss-cross con concordancia aurículo-ventricular y discordancia ventrículo-arterial que ingresó a nuestro centro con disnea y cianosis. En un primer abordaje se le practica atrioseptostomía quirúrgica, sin embargo, en su evolución intrahospitalaria presenta falla cardíaca global refractaria a tratamiento convencional, por lo cual es llevado a nuevamente a cirugía donde se le realiza intervención de Damus-Kaye-Stansel. En el presente artículo se analizan los detalles de la evaluación ecocardiográfica, el cateterismo cardíaco, la resonancia magnética cardíaca y se plantean las opciones quirúrgicas de esta fascinante entidad patológica.
A heart with cross circulation (criss cross) can coexist in the presence of situs solitus or situs inversus, with atrioventricular concordance or discordance, depending on the cardiac rotation over the ventricular longitudinal axis, clockwise or clock counterwise. This is the presentation of the clinical case of a male lactant, with diagnosis of crisscross heart with atrioventricular concordance and ventriculoarterial discordance, who was admitted to these facilities with dyspnoea and cyanosis. In a first approach, a surgical atrioseptectomy was performed on the patient. However, in his intrahospitalary evolution, the patient had a global heart failure refractory to conventional treatment, causing his admission into the operating room for surgery, where the DamusKayeStensel procedure was performed on him. This article presents an analysis of the details of the echocardiographic evaluation, the cardiac catheterization, and the cardiac magnetic resonance of the clinical case, raising the surgical options for this fascinating pathological entity.
Asunto(s)
Humanos , Masculino , Lactante , Atrios Cardíacos/lesiones , Bloqueo Atrioventricular/cirugía , Corazón con Ventrículos Entrecruzados/cirugía , Corazón con Ventrículos Entrecruzados/diagnóstico , Ecocardiografía/métodos , Situs Inversus/patología , Especialidades Quirúrgicas/métodosRESUMEN
Criss cross heart is an extremely rare anomaly accounting for less than 0.1% of congenital heart disease. It is characterized by an abnormal rotation of the heart on its long axis. Almost always there are associated cardiac anomalies such as pulmonary stenosis, ventricular septal defect, ventriculoarterial connection discord or hypoplasia of the tricuspid valve or right ventricle and thereby presenting in the neonatal period. We present a case of a 22 year old woman with a congenitally corrected transposition of great arteries and a criss cross heart.
Asunto(s)
Corazón con Ventrículos Entrecruzados/complicaciones , Corazón con Ventrículos Entrecruzados/diagnóstico , Transposición de los Grandes Vasos/complicaciones , Transposición de los Grandes Vasos/diagnóstico , Adulto , Femenino , Humanos , Adulto JovenRESUMEN
Criss-cross heart is a rare congenital heart defect. The unusual arrangement of the atrio-ventricular connection, and associated abnormalities make it a challenging condition to image. We describe 3 cases of criss-cross heart who underwent cardiac MRI in order to comprehensively evaluate the anatomy and plan surgical management.
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Corazón con Ventrículos Entrecruzados/diagnóstico , Corazón con Ventrículos Entrecruzados/cirugía , Angiografía por Resonancia Magnética/métodos , Angiocardiografía , Procedimientos Quirúrgicos Cardíacos/métodos , Preescolar , Estudios de Cohortes , Medios de Contraste , Femenino , Estudios de Seguimiento , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/cirugía , Humanos , Lactante , Masculino , Medición de Riesgo , Listas de EsperaRESUMEN
At 24 weeks gestational age, a term female infant was diagnosed with complex congenital heart disease. The antenatal cardiac diagnosis was uncertain and included univentricular heart. Following delivery, the child remained well and was normally saturated. Echocardiography and angiocardiography revealed an unusual relationship between atria and ventricles.
Asunto(s)
Anomalías Múltiples/diagnóstico , Corazón con Ventrículos Entrecruzados/diagnóstico , Atrios Cardíacos/anomalías , Ventrículos Cardíacos/anomalías , Angiocardiografía , Diagnóstico Diferencial , Ecocardiografía , Femenino , Estudios de Seguimiento , Atrios Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Recién Nacido , Embarazo , Ultrasonografía PrenatalRESUMEN
A 1-month-old girl was referred at our Institution with a history of heart failure and cyanosis. We established diagnosis of multiple congenital heart disease with criss-crossed atrioventricular connections but concordant. This type of anomaly has a variety of presentations of high diagnostic complexity. The multiple lesions included double outlet of the right ventricle, right subaortic stenosis, ventricular septal defect, coarctation of the aorta with hypoplasia of the arch, and persistent patency of the arterial duct, established through echocardiography, angiocardiography and magnetic resonance. These findings prompted palliative surgery and correction of the aortic arch.
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Corazón con Ventrículos Entrecruzados/diagnóstico , Corazón con Ventrículos Entrecruzados/cirugía , Femenino , Humanos , LactanteRESUMEN
Twisted atrioventricular connections usually occur in hearts with biventricular artioventricular connections. Here, we describe a case of twisted atrioventricular valves associated with double inlet left ventricle and discordant ventriculo-arterial connections. Color Doppler echocardiography, and cine magnetic resonance imaging, clearly demonstrated that the right atrioventricular valve was located anterior and superior to the left atrioventricular valve, and that the axes of the two atrioventricular valves crossed each other within the dominant left ventricle.
Asunto(s)
Corazón con Ventrículos Entrecruzados/diagnóstico , Atrios Cardíacos/anomalías , Ventrículos Cardíacos/anomalías , Ecocardiografía Doppler en Color , Femenino , Humanos , Recién Nacido , Imagen por Resonancia CinemagnéticaRESUMEN
In a case of criss-cross heart with atrioventricular and ventriculoarterial concordance, the right coronary artery and left anterior descending arose from the right hand sinus; the left circumflex originated from the left hand sinus. This pattern existed because of a persistent circle of Vieussens across the right ventricular outflow tract which located superiorly and leftward in such a criss-cross heart.
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Anomalías de los Vasos Coronarios/complicaciones , Corazón con Ventrículos Entrecruzados/complicaciones , Preescolar , Anomalías de los Vasos Coronarios/diagnóstico , Corazón con Ventrículos Entrecruzados/diagnóstico , Humanos , MasculinoRESUMEN
We report a 6-year-old girl with superoinferior ventricles, criss-cross atrioventricular (AV) relationships with solitus atria, a D-loop, L-transposition of the great arteries, subpulmonary stenosis, but without a ventricular septal defect (VSD). The diagnosis was made by echocardiographic examination and was strengthened by cardiac catheterization and angiocardiography. Balloon atrial septostomy in the neonatal period and a modified Blalock-Taussig shunt at the age of 16 months were performed to alleviate hypoxia. Following the shunt operation, the clinical condition of the patient deteriorated with progressive cardiac enlargement, congestive heart failure, and tricuspid regurgitation. We assume that the absence of a VSD contributed to this deterioration. Subsequent improvement was obtained with balloon enlargement of the atrial septal defect and a bidirectional Glenn anastomosis.
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Corazón con Ventrículos Entrecruzados/patología , Defectos del Tabique Interventricular , Angiocardiografía , Cateterismo Cardíaco , Niño , Cineangiografía , Corazón con Ventrículos Entrecruzados/diagnóstico , Corazón con Ventrículos Entrecruzados/cirugía , Ecocardiografía , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , HumanosRESUMEN
Two-dimensional colour Doppler echocardiography was performed on a 1-month-old male infant with criss-cross heart, double outlet right ventricle, ventricular septum defect and pulmonary stenosis. Complex structural abnormalities were suspected after two-dimensional echocardiography (2-D echo) and confirmed by colour Doppler and magnetic resonance imaging (MRI). We stress that the blood streams in the ventricular inflow tracts revealed by colour Doppler and the spatial relationships of the cardiac segments disclosed by MRI are essential to make an accurate non-invasive diagnosis of this complex malformation.