The Morphogenesis of Transposition of the Great Vessels

IN THE COURSE of a study of the embryology of the flow pathways in the human heart,1 it became apparent that there might be a simpler way of looking at the morphogenesis of transposition of the great vessels thani the current torsion-detorsioni theory. To evaluate the validity of the new explanation a comparison was made between the architectural changes found in hearts with proved transposition and the changes to be predicted from this and other theories of its morphogenesis. While there ha-ve been numerous descriptive accounts of the heart in transposition, none has approached it in a systemiatic, semi-quantitative way, with use of objective criteria for case selection. The results are described in the presenit paper. While they agree in all regards with the proposed theory, cardiac development is subtle and many aspects of even normal heart development are poorly understood. It would perhaps be wiser to consider the proposed theory as a "way of looking at transposition" rather than being itself an adequate explanation of its morphogenesis.

[1]  T. Arai,et al.  [ORIGIN OF BOTH GREAT VESSELS FROM THE RIGHT VENTRICLE]. , 1964, Kyobu geka. The Japanese journal of thoracic surgery.

[2]  R. P. Grant,et al.  The Architecture of the Right Ventricular Outflow Tract in the Normal Human Heart and in the Presence of Ventricular Septal Defects , 1961, Circulation.

[3]  Heinz Barthel.  MISSBILDUNGEN DES MENSCHLICHEN HERZENS , 1961 .

[4]  A. C. Witham,et al.  Double outlet right ventricle: A partial transposition complex , 1957 .

[5]  M. V. D. L. Cruz,et al.  An ontogenetic theory for the explanation of congenital malformations involving the truncus and conus , 1956 .

[6]  R. Rowe,et al.  Transposition of the Great Vessels , 1953, Circulation.

[7]  T. Kramer.  The partitioning of the truncus and conus and the formation of the membranous portion of the interventricular septum in the human heart , 1942 .

[8]  S. E. Gould.  Pathology of the heart , 1961 .

[9]  D. Grohmann.  [Mitotic growth potential of embryonic and fetal chicken hearts and its significance for the understanding of heart malformations]. , 1961, Zeitschrift fur Zellforschung und mikroskopische Anatomie.

[10]  K. Goerttler.  [Hemodynamic research on the origin of malformations of the arterial cardiac end]. , 1956, Virchows Archiv fur pathologische Anatomie und Physiologie und fur klinische Medizin.

[11]  R. F. Shaner,et al.  Complete and corrected transposition of the aorta, pulmonary artery and ventricles in pig embryos, and a case of corrected transposition in a child. , 1951, The American journal of anatomy.