Pediatric Cardiology

, Volume 40, Issue 1, pp 237–239 | Cite as

Prenatal Diagnosis of Criss-Cross Heart Using 4-Dimensional Color Doppler Rendering

  • Kiyomi TsukimoriEmail author
  • Yuzo Kitadai
  • Nobuhiko Kan
Images in Pediatric Cardiology


Criss-cross heart is a rare congenital cardiac anomaly characterized by the crossing of two ventricular inflow streams. We have demonstrated the utility of 4-dimensional color Doppler rendering in diagnosing the criss-cross heart in a fetus. Four-dimensional color Doppler rendering can demonstrate the relative direction of intracardiac blood flows and facilitate recognition of the crossover of inflow streams in the same plane, confirming the criss-cross heart diagnosis in the fetus.


Criss-cross heart Prenatal diagnosis 4-Dimensional ultrasound Color Doppler Congenital heart disease 



We have no grants or financial support linked to this work.

Compliance with Ethical Standards

Conflict of interest

There are no conflicts of interest to declare.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from the patient in this study.

Supplementary material

246_2018_1990_MOESM1_ESM.mp4 (912 kb)
Movie 1. Two-dimensional color Doppler (left) and 4-dimensional color Doppler rendering (right) fetal echocardiography at 30 weeks of gestation. Four-dimensional color Doppler rendering showed simultaneously crossing bloodstreams of the 2 inlets in the transverse plane of the fetal chest, resulting in the criss-cross appearance. The spatial arrangement of the 2 atrioventricular inlets can be recognized clearly. (MP4 912 KB)


  1. 1.
    Ngeh N, Api O, Iasci A, Ho S, Carvalho J (2008) Criss-cross heart: report of three cases with double-inlet ventricles diagnosed in utero. Ultrasound Obstet Gynecol 3:461–465CrossRefGoogle Scholar
  2. 2.
    Li S, Luo G, Norwitz ER, Wang C, Ouyang S, Yao Y, Wen H, Chen C, Fu Q, Xia X, Bi J, Zhu J (2013) Prenatal diagnosis of criss-cross heart: sonographical and pathological features of five cases. J Perinatol 33:98–102CrossRefGoogle Scholar
  3. 3.
    Ravi P, Fruitman D, Mills L, Colen T, Hornberger LK (2017) Prenatal diagnosis of the criss-cross heart. Am J Cardiol 119:916–922CrossRefGoogle Scholar
  4. 4.
    Hata T, AboEllail MAM, Sajapala S, Ito M (2015) HDliveFlow in the assessment of fetal circulation. Donald School J Ultrasound Obstet Gynecol 9:462–470CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics, Perinatal CenterFukuoka Children’s HospitalFukuokaJapan
  2. 2.Department of Neonatal Cardiology, Perinatal CenterFukuoka Children’s HospitalFukuokaJapan

Personalised recommendations