{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T01:25:33Z","timestamp":1781659533540,"version":"3.54.5"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2002Criss-cross heart (CCH) is a rare congenital cardiac defect defined by crossing of ventricular inflow streams contributing to less than 0.1\u200a% of all congenital heart anomalies. Due to its rarity and complexity, prenatal diagnosis in these patients remains challenging. We sought to describe prenatal findings and postnatal course in eight cases of prenatally diagnosed CCH.<\/jats:p><jats:p>\n          Methods\u2002This is a retrospective case series of prenatally diagnosed CCH in three centers between 2010\u20132017. We reviewed fetal echocardiograms as well as postnatal clinical charts and surgical reports.<\/jats:p><jats:p>\n          Results\u20028 cases of CCH were included. The median gestational age at diagnosis was 27 weeks. 7 patients were found with situs solitus, one fetus with situs ambiguous. In all patients, the four-chamber view was abnormal. There was atrioventricular discordance in half of the patients, while all patients showed ventriculoarterial discordance. All patients were found with additional cardiac anomalies, including ventricular septal defect, double outlet right ventricle, right aortic arch, atrial septal defect and pulmonary stenosis. Three patients underwent amniocentesis without pathological findings. All\u00a0patients were born alive at a median gestational age of 38\u200a+\u200a2 weeks and survived our median follow-up of 181 days.<\/jats:p><jats:p>\n          Conclusion\u2002CCH can be diagnosed prenatally by detailed fetal echocardiography when observing an abnormal four-chamber view with crossing of inflow streams into both ventricles and a lack of parallel orientation of the atrioventricular valve axis due to a clockwise or counterclockwise rotation of the ventricular mass along its axis. With the help of prenatal ultrasound, parental guidance and counselling as well as postnatal pediatric cardiac management can be warranted.<\/jats:p>","DOI":"10.1055\/a-1205-0289","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T22:58:06Z","timestamp":1594940286000},"page":"e90-e97","source":"Crossref","is-referenced-by-count":5,"title":["Prenatal Diagnosis and Postnatal Outcome of Eight Cases with\u00a0Criss-Cross\u00a0Heart \u2013 A Multicenter Case Series"],"prefix":"10.1055","volume":"43","author":[{"given":"Carina Nina","family":"Vorisek","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrii","family":"Kurkevych","sequence":"additional","affiliation":[{"name":"Fetal Cardiology Unit, Ukrainian Children's Hospital, Kyiv, UA, Kyiv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Stessig","sequence":"additional","affiliation":[{"name":"Practice for Prenatal Care, Praenatal plus, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Ritgen","sequence":"additional","affiliation":[{"name":"Practice for Prenatal Care, Praenatal plus, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"Practice for Prenatal Care, Praenatal plus, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Enzensberger","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Wolter","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malena","family":"G\u00f6tte","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Akint\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Surgery, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Axt-Fliedner","sequence":"additional","affiliation":[{"name":"Division of Prenatal Medicine, Department of Obstetrics and Gynecology, Justus-Liebig-University and UKGM, Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,7,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/0002-9149(61)90209-0","article-title":"The pathologic anatomy of mixed levocardia","volume":"8","author":"M Lev","year":"1961","journal-title":"Am J Cardiol [Internet]"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/BF02427032","article-title":"Criss-cross hearts revisited","volume":"3","author":"R H Anderson","year":"1982","journal-title":"Pediatr Cardiol [Internet]"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1161\/01.CIR.50.1.176","article-title":"Criss-cross atrioventricular relationships producing paradoxical atrioventricular concordance or discordance. Their significance to nomenclature of congenital heart disease","volume":"50","author":"R H Anderson","year":"1974","journal-title":"Circulation [Internet]"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/BF02306745","article-title":"Isolated ventricular inversion: Two-dimensional echocardiographic findings and a review of the literature","volume":"5","author":"A R Snider","year":"1984","journal-title":"Pediatr Cardiol [Internet]"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1002\/uog.12403","article-title":"ISUOG Practice Guidelines (updated): sonographic screening examination\u200aof the fetal heart","volume":"41","author":"J Carvalho","year":"2013","journal-title":"Ultrasound Obstet Gynecol [Internet]"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1007\/s00246-006-1153-2","article-title":"A criss-cross heart with twisted atrioventricular connections, &quot;perfect streaming,&quot; and double discordance","volume":"27","author":"W J Duncan","year":"2006","journal-title":"Pediatr Cardiol [Internet]"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5935\/1678-9741.20130014","article-title":"Criss-cross heart: report of\u00a0two cases, anatomic and surgical description and literature review","volume":"28","author":"\u00cd M de Oliveira","year":"2013","journal-title":"Rev\u00a0Bras Cir Cardiovasc [Internet]"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s12574-017-0339-3","article-title":"Prenatal three-dimensional color Doppler imaging showing crossover of the inflow streams of two ventricles in a case of criss-cross heart","volume":"15","author":"A Shirakawa","year":"2017","journal-title":"J Echocardiogr [Internet]"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/jp.2012.56","article-title":"Prenatal diagnosis of criss-cross heart: sonographical and pathological features of five cases","volume":"33","author":"S Li","year":"2013","journal-title":"J Perinatol [Internet]"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1017\/S1047951100009732","article-title":"Fetal echocardiographic features of twisted atrioventricular connections","volume":"10","author":"M Abdullah","year":"2000","journal-title":"Cardiol Young [Internet]"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1002\/uog.5300","article-title":"Criss-cross heart: report of three cases with double-inlet ventricles diagnosed in utero","volume":"31","author":"N Ngeh","year":"2008","journal-title":"Ultrasound Obstet Gynecol [Internet]"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1016\/j.amjcard.2016.11.046","article-title":"Prenatal Diagnosis of the Criss-Cross Heart","volume":"119","author":"P Ravi","year":"2017","journal-title":"Am J Cardiol [Internet]"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/S0022-5223(19)38187-5","article-title":"Surgical repair of criss-cross heart with straddling atrioventricular valve","volume":"77","author":"G K Danielson","year":"1979","journal-title":"J Thorac Cardiovasc Surg [Internet]"}],"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1205-0289.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T15:17:24Z","timestamp":1676042244000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1205-0289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,16]]},"references-count":13,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2022,12,5]]},"published-print":{"date-parts":[[2022,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1205-0289","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"value":"0172-4614","type":"print"},{"value":"1438-8782","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,16]]}}}