Criss cross heart; a challenging diagnosis, case series

Sheikh, Abdul Malik; Kanwal, Asma; Sattar, Hina

doi:10.47391/jpma.3162

Cited by 3 publications

(2 citation statements)

References 8 publications

(13 reference statements)

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“…Крисс-кросс (criss-cross) синдром (или крисскросс сердце) -это редкий, орфанный врожденный порок сердца, характеризующийся перекрещиванием потоков крови, поступающей из предсердий в желудочки. Патология возникает в результате скручивания сердца вокруг длинной оси в процессе эмбриогенеза [1]. Частота встречаемости по данным международной литературы составляет 8 на 1 млн новорожденных, что составляет менее 0,1 % всех врожденных пороков сердца ВПС [1,2].…”

Section: Introductionunclassified

“…Патология возникает в результате скручивания сердца вокруг длинной оси в процессе эмбриогенеза [1]. Частота встречаемости по данным международной литературы составляет 8 на 1 млн новорожденных, что составляет менее 0,1 % всех врожденных пороков сердца ВПС [1,2].…”

Section: Introductionunclassified

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Criss-cross heart: a clinical case of a rare congenital heart defect in a newborn

Starkov¹,

Shestak

2023

jour

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Introduction. Criss-cross syndrome is a rare congenital heart disease with an incidence of 8 cases per 1 million newborns. The purpose of the work is to demonstrate a rare CHD, a criss-cross heart diagnosed postnatally. The purpose of the work was to demonstrate a rare CHD, a criss-cross heart diagnosed postnatally. Materials and methods. A clinical observation of a newborn child with a rare congenital heart defect is presented. Medical documents with the results of clinical examination (physical examination) and instrumental examinations (X-ray examination, echocardiography, computed tomography) were used for analysis. Results. A child with a rare congenital heart defect (CHD) – criss-cross heart with discordant atrioventricular connections, transposition of the great vessels and preductal aortic coarctation was monitored from the time of delivery until surgical treatment. This malformation was diagnosed postnatally, based on the characteristic clinical symptoms of the detailed segmental analysis of the ultrasound picture of the heart, which is presented as illustrations. Timely diagnosis allowed the choice of adequate medication and surgical tactics of treatment, and the diagnosis was confirmed by computed tomography. Discussion. It is important for the clinician to remember that rare congenital heart diseases cannot always be diagnosed antenatally, and with the results of screening indicating the presence of more common malformations, the real postnatal heart picture may differ significantly. An additional difficulty is the differential diagnosis of the described malformation due to the rare anomalous mutual arrangement of the anatomical structures. Conclusion. Detailed segmental analysis during echocardiography immediately after birth reveals the main diagnostic marker of criss-cross syndrome – inability to simultaneously visualize all four heart chambers and both atrioventricular valves from a four-chamber position.

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Section: Introductionunclassified

Criss-cross heart: a clinical case of a rare congenital heart defect in a newborn

Starkov¹,

Shestak

2023

jour

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Epidemiological, Clinical and imaging features, and outcome of patients with Crisscross heart disease: A Systematic review of 46 published case reports

Ramadan,

Roshdy,

Hamad

et al. 2023

Preprint

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Background and objectives The crisscross heart (CCH) is a rare congenital cardiac abnormality defined by the crossing of the inflow streams of the two ventricles due to the heart's apparent twisting about its long axis. Despite being considered a defect, the CCH is more of a spatial than a functional aberration, so the heart can still work normally. The severity of this anomaly is determined by the difficulty of knowing the obscurity of the etiology, the lack of early diagnosis, and the exacerbation of its symptoms. The choice of optimal surgical interventions for managing complex heart defects leads to a marked reduction in morbidity and mortality incidence. We conducted this study to provide a summary and critical evaluation of the existing evidence knowledge on the nature of this defect and to emphasize the importance of early diagnosis. Methods We searched PubMed, Scopus, Web of Science, and Embase databases in addition to cross-checking against the bibliographies of retrieved articles to identify additional reports until September 15th,2022. Results Our inclusion criteria are met by 46 case reports, which include 101 patients of both sexes ≥1 month of age, published from 1974 to 2021. CCH was diagnosed in 45 (44.6%) females and 56 (55.4%) males with a median age of 66 months [interquartile range (IQR): 12-216 months] who came from 19 countries worldwide. The common clinical features manifested with dyspnea in 17 (16.8%), cyanosis in 39 (38.6%), and tachycardia in 12 (11.9%) patients. The most common associated congenital heart diseases were ventricular septal defect in 85 (84.3%) patients, double outlet right ventricle in 52 (51.5%) patients, and pulmonary stenosis in 62 (61.4%) patients. The Surgical intervention took place in 65.4% of the patients. A two-ventricle repair may not be possible in most patients, and these patients are prepared for a Fontan-type surgery. Conclusion Understanding this complex congenital heart disease allows clinicians to provide their patients with the best care and prompt intervention. Further investigation of the histopathology pictures and genetic sequences is needed to determine a clear pathogenesis.

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Case report: Use of three-dimensional technology in criss-cross heart with double outlet right ventricle

Alifu¹,

Wang²,

Su³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundIn this case report, we utilized a three-dimensional printing model to replicate the complex anatomy of a criss-cross heart with double outlet right ventricle—an extremely rare congenital cardiac abnormality. This approach facilitated our understanding of the patient's unique condition and enabled us to plan the surgical procedure with greater precision.Case presentationOur department received a 13-year-old female patient who presented with a pronounced heart murmur and a decrease in exercise capacity. Subsequent two-dimensional imaging revealed the presence of a criss-cross heart with double outlet right ventricle—an intricate and uncommon cardiac malformation that poses challenges for accurate visualization through conventional two-dimensional modalities. To address this challenge, we constructed and printed a three-dimensional model using computed tomography data, which enabled us to visualize and understand the complex intracardiac structures and plan surgical interventions with greater precision. Using this approach, we successfully performed a right ventricular double outlet repair, and the patient made a full recovery following the procedure.ConclusionThe criss-cross heart with double outlet right ventricle constitutes a complex and uncommon cardiac anomaly that poses considerable challenges in terms of diagnosis and surgical intervention. Employing three-dimensional modeling and printing represents a promising approach, given its potential to enhance the precision and comprehensiveness of the anatomical evaluation of the heart. As a result, this method holds significant promise in facilitating accurate diagnosis, meticulous surgical planning, and ultimately improving clinical outcomes for patients affected by this condition.

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Criss cross heart; a challenging diagnosis, case series

Cited by 3 publications

References 8 publications

Criss-cross heart: a clinical case of a rare congenital heart defect in a newborn

Criss-cross heart: a clinical case of a rare congenital heart defect in a newborn

Epidemiological, Clinical and imaging features, and outcome of patients with Crisscross heart disease: A Systematic review of 46 published case reports

Case report: Use of three-dimensional technology in criss-cross heart with double outlet right ventricle

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