A criss-cross heart with concordant atrioventriculo-arterial connections. Report of a case.

A distinctive angiographic appearance is described in a case of "criss-cross" heart with concordant atrioventriculo-arterial connections. The atrial situs was normal, and the morphological right ventricle was superior to the left ventricle, and the ventricular septum was horizontal in position. Both ventricleswere connected by a small ventricular septal defect. The aorta was situated anteriorly and to the right of the pulmonary artery. Although the cardiac segment was the apparent [S,L,D] type, the heart had conconrdant atrioventriculo-arterial connections. The ventricular rotation of the solitus heart about the longitudinal and the anteroposterior axis affected the atrioventricular flows, the plane of the ventricular septum, the inflow and outflow tracts of the ventricles, the interrelationship of the great arteries, and the course of the left coronary artery. Using the recent definition of criss-cross heart, we classified the heart as solitus-concordant (l-rotated) -normal.