超声心动图对十字交叉心脏的诊断价值

目的探讨超声心动图对十字交叉心脏（crisscross heart，CH）的诊断价值，并讨论超声心动图的表现特征。方法自2004年4月至2005年7月应用超声心动图的二维图像，多普勒及彩色多普勒对3例CH解剖及血流动力学异常进行观察，将其声像图表现与心血管造影、手术结果对比分析，总结其诊断特点。结果3例CH的超声心动图特征是：心房均为正位，1例心房与心室连接关系一致，2例不一致；3例均为房室瓣呈前上（三尖瓣）、后下（二尖瓣）垂直排列，而非左右并列；右心室位于前、上，左心室位于后、下；室间隔呈水平，伴巨大室缺；1例二尖瓣骑跨在室间隔上，1例三尖瓣发育不良；3例均合并大动脉转位，2例合并右室双出口，2例合并肺动脉狭窄，1例合并肺动脉高压。超声诊断均与心血管造影、手术结果符合。结论超声心动图诊断CH具有较高的准确性，心室呈上下结构及心房与心室交叉连接是诊断十字交叉心脏的重要依据。

Criss-cross Heart Evaluated by Echocardiography

Objective To study the echocardiographic diagnosis value and to discuss the features of criss-cross heart.Methods Three cases of criss-cross heart from April 2004 to July 2005 were studied.The diagnosis was confirmed by echocardiography.The echocardiographic characteristics were compared with the results of cardiac catheterization and operation.The echocardiographic features were summarized.Results The echocardiographic characteristics were:The visceroatrial situs was solitus in all patients A concordant atrioventricular connection was in 1 patient and a discordant in 2.In all patients,the right ventricle(tricuspid valve) was located anterior-superiorly and the left ventricle(mitral valve) posterior-inferiorly.There was horizontal ventricular septum and huge VSD in all patients.Frequently associated anomalies included that the mitral valve straddled on the ventricular septum(1 patient),hypoplastic tricuspid valve 1,malposition of the great arteries 3,double-outlet right ventricle 2,pulmonary artery stenosis 2 and pulmonary hypertension 1.The echocardiographic characteristics of criss-cross heart were correspondent to the results of cardiac catheterization and operation.Conclusions Echocardiography for the diagnosis of criss-cross heart has high accurate rate.The superior inferior positioning of the two ventricles and the atrio-ventricular crossing connections are the two important features of criss-cross heart on echocardiography.