Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-21T09:48:49.943Z Has data issue: false hasContentIssue false

The problems that exist when considering the anatomic variability between the channels that permit interventricular shunting

Published online by Cambridge University Press:  27 May 2014

Frédérique Bailliard
Affiliation:
Bailliard Henry Pediatric Cardiology, Raleigh, North Carolina, United States of America
Diane E. Spicer
Affiliation:
Congenital Heart Institute of Florida, St Petersburg, Florida, United States of America Division of Developmental Biology, MRC National Institute for Medical Research, London, United Kingdom
Timothy J. Mohun
Affiliation:
Emeritus Founding Editor, Chapel Hill, North Carolina, United States of America
G. William Henry
Affiliation:
Emeritus Founding Editor, Chapel Hill, North Carolina, United States of America
Robert H. Anderson*
Affiliation:
Institute of Genetic Medicine, Newcastle University, Newcastle, United Kingdom
*
Correspondence to: Professor R. H. Anderson, 60 Earlsfield Road, London SW18 3DN, United Kingdom. Tel: +00 44 20 8870 4368; E-mail: sejjran@ucl.ac.uk

Abstract

Although steps are being taken to produce a universally acceptable coding system for categorisation of the congenitally malformed hearts, obstacles remain in the search for consensus. One of the groups of lesions continuing to produce the greatest problems is those that permit interventricular shunting. The difficulties relate partly to the words used to describe the group itself, as those using Germanic languages describe the holes as ventricular septal defects, whereas those using Romance languages consider them to represent interventricular communications. The two terms, however, are not necessarily synonymous. Further disagreements relate to whether the lesions placed within the group should be sub-categorised on the basis of their geographical location within the ventricular mass, as opposed to the anatomic nature of their borders. In reality, attention to both the features is necessary if we are to recognise the full extent of phenotypic variability. In this review, we first review the evolution and theories of analysis naming the channels that permit interventricular shunting. We then demonstrate that embryologic techniques provide evidence that the changing morphology of the developing murine heart parallels the anatomy of the different lesions encountered in the congenitally malformed human heart. We suggest that, with attention paid to the temporal development of the normal murine heart, combined with a strict definition of the plane of separation between the right and left ventricular cavities, it will be feasible to produce a categorisation that is acceptable to all.

Type
Review Articles
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Capelli, H, Andrade, JL, Somerville, J. Classification of the site of ventricular septal defect by 2-dimensional echocardiography. Am J Cardiol 1983; 51: 14741480.CrossRefGoogle ScholarPubMed
2. Anderson, RH, Spicer, DE, Giroud, J, Mohun, TJ. Tetralogy of Fallot: nosological, morphological, and morphogenetic considerations. Cardiol Young 2013; 23: 857865.CrossRefGoogle ScholarPubMed
3. Von Rokitansky, C. Die Defecte der Scheidewände des Herzens. Wilhelm Braumüller, Wien, 1875.Google Scholar
4. Peacock, TB. Malformations of the Human Heart, 2nd edn. John Churchill and Sons, London, 1866.Google Scholar
5. Abbott, ME. Atlas of Congenital Cardiac Disease. American Heart Association, New York, 1936: 3637.Google Scholar
6. Taussig, HB. Congenital Malformations of the Heart. The Commonwealth Fund, New York, 1947: 390417.Google Scholar
7. Wood, P. Diseases of the Heart and Circulation, 2nd edn. Eyre and Spottiswood, London, 1963: 371372.Google Scholar
8. Becu, LM, Fontana, RS, Dushane, JW, Kirklin, JW, Burchell, HB, Edwards, JE. Anatomic and pathologic studies in ventricular septal defect. Circulation 1956; 14: 349364.Google Scholar
9. Sherman, FE. An Atlas of Congenital Heart Disease. Henry Kimpton, London, 1963: 166186.Google Scholar
10. Rosenquist, GC, Sweeney, LJ, Stemple, DR, Christianson, SD, Rowe, RD. Ventricular septal defect in tetralogy of Fallot. Am J Cardiol 1973; 31: 749754.Google Scholar
11. Wells, WJ, Lindesmith, GG. Ventricular septal defect. In: Arciniegas E (ed.). Pediatric Cardiac Surgery. Year Book Medical Publishers, Chicago, IL, 1985.Google Scholar
12. Soto, B, Becker, AE, Moulaert, AJ, Lie, JT, Anderson, RH. Classification of ventricular septal defects. Br Heart J 1980; 43: 332343.CrossRefGoogle ScholarPubMed
13. Lev, M, Bharati, S, Meng, CC, Liberthson, RR, Paul, MH, Idriss, F. A concept of double-outlet right ventricle. J Thorac Cardiovasc Surg 1972; 64: 271281.CrossRefGoogle ScholarPubMed
14. Soto, B, Ceballo, R, Kirklin, JK. Ventricular septal defects: a surgical viewpoint. J Am Coll Cardiol 1989; 14: 12911297.Google Scholar
15. Van Praagh, R, Geva, T, Kreutzer, J. Ventricular septal defects: how shall we describe, name and classify them? J Am Coll Cardiol 1989; 14: 12981299.CrossRefGoogle Scholar
16. Anderson, RH, Becker, AE, Van Mierop, LHS. What should we call the “crista”? Br Heart J 1977; 39: 856859.CrossRefGoogle ScholarPubMed
17. Capuani, A, Uemura, H, Ho, SY, Anderson, RH. Anatomic spectrum of abnormal ventriculoarterial connections: surgical implications. Ann Thorac Surg 1995; 59: 352360.Google Scholar
18. Hosseinpour, A-R, Jones, TJ, Barron, DJ, Brawn, WJ, Anderson, RH. An appreciation of the structural variability in the components of the ventricular outlets in congenitally malformed hearts. Eur J Cardio-Thorac Surg 2007; 31: 888893.CrossRefGoogle ScholarPubMed
19. Abbott, ME. Atlas of Congenital Cardiac Disease. American Heart Association, New York, 1936: 23.Google Scholar
20. Mohun, TJ, Weninger, WJ. Imaging heart development using high-resolution episcopic microscopy. Curr Opin Genet Dev 2011; 21: 573578.CrossRefGoogle ScholarPubMed
21. Moorman, AFM, Christoffels, VM. Cardiac chamber formation: development, genes, and evolution. Physiol Rev 2003; 83: 12231267.Google Scholar
22. Kramer, TC. The partitioning of the truncus and conus and the formation of the membranous portion of the interventricular septum in the human heart. Am J Anat 1942; 71: 343370.CrossRefGoogle Scholar
23. Anderson, RH, Chaudhry, B, Mohun, TJ, et al. Normal and abnormal development of the intrapericardial arterial trunks in humans and mice. Cardiovasc Res 2012; 95: 108115.CrossRefGoogle ScholarPubMed
24. Lamers, WH, Wessels, A, Verbeek, FJ, et al. New findings concerning ventricular septation in the human heart. Implications for maldevelopment. Circulation 1992; 86: 11941205.Google Scholar
25. Sizarov, A, Anderson, RH, Mohun, TJ, Brown, NA, Lamers, WH, Moorman, AFM. Three dimensional and molecular analysis of the arterial pole of the developing human heart. J Anat 2012; 220: 336349.Google Scholar
26. Anderson, RH, Mohun, TJ, Moorman, AFM. What is a ventricle? Cardiol Young 2012; 21: 1422.CrossRefGoogle ScholarPubMed
27. Baker, E, Leung, MP, Anderson, RH, Fischer, DR, Zuberbuhler, JR. The cross-sectional anatomy of ventricular septal defects: a reappraisal. Br Heart J 1988; 59: 339351.Google Scholar