Criss-cross heart: report of two cases, anatomic and surgical description and literature review

Abstract

ResumoCoração entrecruzado (criss-cross heart) é uma anomalia extremamente rara, caracterizada por rotação anormal da massa ventricular ao longo do seu eixo maior e pode estar associada com qualquer malformação dos segmentos e das conexões entre as câmaras cardíacas. Devido às alterações estruturais complexas e à raridade da anomalia, essa anomalia de rotação é muitas vezes mal diagnosticada. Neste trabalho são relatados dois casos de coração entrecruzado com ênfase no diagnóstico morfológico e nas técnicas cirúrgicas utilizadas. Foi também realizada revisão da literatura sobre o assunto, que, embora escassa, foi enfatizada quanto à morfologia, diagnóstico, abordagem cirúrgica e possíveis complicações.Descritores: Anormalidades congênitas. Procedimentos cirúrgicos cardíacos. Coração entrecruzado. AbstractCriss-cross heart is an extremely rare anomaly, characterized by an abnormal rotation of the ventricular mass along its major axis. It may be associated with any malformation of the heart segments and connections. Due to the complex structural changes and rarity of the anomaly, the rotation of ventricular axis is often misdiagnosed. In this paper, two cases of criss-cross heart are reported, with emphasis on diagnostic and surgical techniques used to corrected the main defects. A literature review on the subject is also presented which, although sparse, emphasized on the morphologic, diagnostic and surgical aspects of the anomaly.Descriptors: Congenital abnormalities. Cardiac surgical procedures. Crisscross heart. REVIEW ARTICLE 94Rev Bras Cir Cardiovasc 2013;28(1):93-102 Oliveira IM, et al. -Criss-cross heart: Report of two cases, anatomic and surgical description and literature review

Cardiac CT of a Criss-Cross Heart: A Case Report

“…Such an anomaly results from abnormal rotation of the ventricular components about their long axis due to unclear causes. With such an abnormality, the flow from the systemic and pulmonary venous systems intersects at the ventricular inlet level without mixing of blood(1).The criss-cross heart is typically associated with a multitude of congenital cardiac defects, such asVSD, transposition of the great arteries, right ventricular hypoplasia, pulmonary stenosis and several others (1,(4)(5)(6).…”

Abstracts SA Heart Congress 2014

“…Most patients have ventricular septal defects, abnormal ventriculo-arterial connections, RV outfl ow tract obstruction, atrial septal defects and hypoplastic RVs. (1,2) Introduction: Rheumatoid arthritis (RA) is a multi-system, autoimmune disorder and is one of the strongest known risk factors for cardiovascular disease (CVD) morbidity and mortality. Endothelial dysfunction, accelerated atherosclerosis, vascular infl ammation and myocarditis are thought to contribute to this excess CVD.…”

“…(1)(2)(3) It occurs due to twisting of the ventricular muscle along its long axis during embryonic development and is characterised by a superior-inferior orientation of the ventricles (SIV) with the right ventricle (RV) lying superiorly and the left ventricle (LV) inferiorly. There is atrioventricular (AV) concordance with crossed ventricular infl ow streams (CIS).…”

“…There is atrioventricular (AV) concordance with crossed ventricular infl ow streams (CIS). (1)(2)(3) Due to both the rarity of the condition and its associated defects, diagnosis by transthoracic echocardiogram (TTE) remains challenging. We report a case of CCH with double outlet RV (DORV) in a 15-year-old boy.…”

“…The diagnosis of CCH depends on identifying the SIV arrangement with CIS. (1)(2)(3) The presence of SIV is defi ned as the horizontal alignment of the interventricular septum on either the parasternal or subcostal short axis views with the RV lying above the LV.…”