This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Marino, B. Articles by Mileto, F. Search for Related Content PubMed PubMed Citation Articles by Marino, B. Articles by Mileto, F. Related Collections Cardiac development

(Circulation. 2002;106:e223.)
© 2002 American Heart Association, Inc.

Correspondence

Criss–Cross Heart With D–Ventricular Loop

Bruno Marino, MD; Federica Mileto, MD

Pediatric Cardiology, Institute of Pediatrics, University of Rome "La Sapienza", Rome, Italy, bruno.marino@uniroma1.it

To the Editor:

In a recent issue of Circulation, we saw the interesting images concerning magnetic resonance angiography in a patient with criss–cross heart.¹ In the description of the case, the authors correctly report the atrial situs (solitus), the position of the ventricle (inverted), and the connection of the great arteries (discordant with L–position of the aorta).

This is the most frequent anatomical pattern of criss–cross heart.² Despite the inverted position of the ventricle, however, these patients have a D–ventricular loop, not a L–ventricular loop as suggested by the authors.¹ In fact, the atrioventricular connections are concordant and the topology of the right ventricle is of the "right hand" type.^2,4,5 The case reported by the authors¹ is a "complete transposition of great arteries" with an exaggerated D–looping movement bringing the anatomic right ventricle to the left and causing the crossed atrioventricular connections. By contrast, the criss–cross heart with L–ventricular loop is a "congenitally corrected transposition of great arteries" with an exaggerated L–looping movement that brings the anatomic right ventricle to the right, maintaining its "left hand" topology.^4,5 Authors who have described criss–cross heart previously are in agreement with this anatomic description of the ventricular loop and with this embryological explanation.^2–5

References

1. Araoz PA, Reddy GP, PD, Higgins CB. Magnetic resonance angiography of criss–cross heart. Circulation. 2002; 105: 537–538.[Free Full Text]

2. Marino B, Sanders S, Pasquini L, et al. Two–dimensional echocardiographic anatomy in criss–cross heart. Am J Cardiol. 1986; 58: 325–333.[CrossRef][Medline] [Order article via Infotrieve]

3. Tadavarthy SM, Formanek A, Castaneda–Zuniga W, et al. The three types of criss–cross heart: a simple rotational anomaly. Br J Radiol. 1981; 54: 736–743.[Abstract/Free Full Text]

4. Anderson RH. Criss–cross hearts revisited. Pediatr Cardiol. 1982; 3: 305–312.[CrossRef][Medline] [Order article via Infotrieve]

5. Van Praagh R. Nomenclature and classification: morphologic and segmental approach to diagnosis. In: Moller JH, Hoffman JIE, eds. Pediatric Cardiovascular Medicine. Philadelphia, Pa: Churchill Livingstone; 2000.

This Article Extract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Marino, B. Articles by Mileto, F. Search for Related Content PubMed PubMed Citation Articles by Marino, B. Articles by Mileto, F. Related Collections Cardiac development