Criss-cross heart with complex cardiac malformation, situs inversus totalis and bronchial dysplasia

Background: Criss-cross heart (CCH) is a rare congenital heart malformation characterized by twisted atrioventricular connections, often associated with various other cardiac anomalies, making accurate diagnosis challenging; In this article, we present a previously unreported case of CCH with complex cardiac malformation, situs inversus totalis, and bronchial dysplasia. Case presentation: A 10-year-old girl presented with recurrent cyanosis and fatigue, and echocardiography revealed a complex congenital heart condition involving CCH, dextrocardia, severe pulmonary hypertension, ventricular septal defect (VSD), atrial septal defect (ASD), and patent ductus arteriosus (PDA). Further CT angiography unveiled bronchial dysplasia and double-outlet right ventricle (DORV). Conclusions: CCH is a rare congenital heart condition characterized by twisted atrioventricular connections, with complex associated anomalies. Diagnosis is challenging due to the variety of defects. CT angiography is crucial for comprehensive assessment and surgical planning. This case presented a unique combination of CCH with mirror dextrocardia, situs inversus totalis, and bronchial malformation, highlighting the importance of CT in guiding treatment decisions. However, postoperative follow-up is lacking, and optimal surgical strategies for such complex deformities remain to be explored.