The criss-cross and superoinferior ventricular heart: an angiocardiographic study |
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Authors: | R M Freedom G Culham R D Rowe |
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Affiliation: | 1. From the Division of Cardiology, Departments of Paediatrics, Pathology and Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada;2. From the Departments of Paediatrics, Pathology and Radiology, The University of Toronto, Toronto, Ontario, Canada |
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Abstract: | The angiocardiographic features of 11 patients with superoinferior and criss-cross type of atrioventricular (A-V) connections are presented. These unusual ventricular relations are thought to result from postseptation disturbances of ventricular looping. The angiocardiographic appearance of criss-cross is really an illusion, and the A-V connections among these patients are either concordant, discordant or straddling. The often small right A-V valve inflow and sinus portion of the ventricle, combind with the ventricular rotational anomaly, combine to give the angiocardiographic perception of criss-cross. A review of the 11 patients from this institution and those previously reported on suggests that most patients have a transposition of malposition of the great arteries; many have a small right ventricle, and about half have pulmonary outflow tract obstruction. In addition to the obvious embryologic, morphologic and clinical implications of these distorted ventricular loops, the criss-cross A-V hearts raise questions about the various segmental nomenclatures applied to these types of congenital heart disease. |
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Keywords: | Address for reprints: Robert M. Freedom MD The Hospital for Sick Children 555 University Avenue Toronto Ontario Canada M5G 1X8. |
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