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Sequential segmental analysis - description and categorization for the millennium

Published online by Cambridge University Press:  19 August 2008

Robert H. Anderson  and
Siew Yen Ho
Robert H. Anderson*
Affiliation:
Paediatrics, Imperial College shool of Medicine at National Heart and Lung Institute, London, UK
Siew Yen Ho
Affiliation:
Paediatrics, Imperial College shool of Medicine at National Heart and Lung Institute, London, UK
*
Professor RH Anderson, Paediatrics, National Heart and Lung Institute, Dovehouse Street, London SW3 6LYUK. Tel: 010-44-71-351 8751. Fax: 010-44-71-351-8230
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Abstract

The concept of sequential analysis of congenitally malformed hearts is now widely accepted, although some aspects remain controversial. In this review, we analyse the evolution of the scgmental approach, showing how our own concepts of analysis have chaanged little since our initial description, heart dicrates the presence of the atrial, ventriclar, and arterial segments, Analysis depends upon recognizing the morphologic differences of the components within each segment, and then how these parts are joined together across the atrioventicular and ventriculo-arterial Junctions. The distinction of chambers and arterial trunks follows the principle of the morphologic method, namely that scructures be identified on the basis of their own intrinsic morphology, and not according to other features which themselves might be variable. Differentiation of junctional arrangements as opposed to segmental stucture resolves ongoing controversics such as the nature of “univentricular hearts”.Analysis in the fashion proposed shows that there is nothing intrinsically complicated with malformed hearts.

Keywords

Congenital cardiac malformationsnomenclatureclassification
Type
Continuing Medical Education
Information
Cardiology in the Young , Volume 7 , Issue 1 , January 1997 , pp. 98 - 116
Copyright
Copyright © Cambridge University Press 1997

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References

1.de la, Cruz MV, Berrazueta, JR, Arteaga, M, Attie, F, Soni, J. Rules for diagnosis of arteroventricular discordances and spatial identification of ventricles. Br Heart J 1976; 38:341–354.CrossRefGoogle Scholar
2.Van Praagh, R. The segmental approach to diagnosis in congenical heart disease. In: Bergsma, D (ed). Birth Defects: Original Article Series, Volume VIII, No. 5. The National Foundation ndash; March of Dimes. Baltimore: Williams and Wilkins, 1972; pp 4–23.Google Scholar
3.Anderson, RH. How should we optimally describe complex congenitally malformed hearts? Ann Thorac Surg 1996; 62:710–716.CrossRefGoogle ScholarPubMed
4.Ven Praagh, R. Tetralogy of Fallott {S, D, I}: A recently discovered malformation and its surgical management Ann Thorac surg 1995;60 1165–1165.Google Scholar
5.de la, Cruz MV, Nadal-Ginard, B. Rules for the diagnosis of visceralsitus, truncoconal morphologies and ventricular inversions Am Heart J 1972;84:19–32.CrossRefGoogle Scholar
6.Van Praagh, R, Ongley, PA, Swan, HJC. Anatomic types of single or common ventricle in man: morphologic and geometric aspects of sixty necropsied cases. Am J Cardiol 1964;13:367–386.CrossRefGoogle Scholar
7.Van Praagh, R, Van Praagh, S, Vlad, P, Keith, JD. Anatomic types of congenital dexrocardia. Diagnostic and embrtologic implications. Am J Cardiol 1964;13:510–531.CrossRefGoogle Scholar
8.Anderson, RH. Editorial note: The anatomy of arterial valve stenbosis. Int J Cardiol 1990;26:355–359.CrossRefGoogle Scholar
9.Van Praagh, R, David, I, Wright, GBVen Praagh, SLarge Rv plus small LV is not single RV. Circulation 1980 61:1057–1058.CrossRefGoogle Scholar
10.Macartney, FJ, Zuberbuhler, JR, Anderson, RH. Morphological considertions pertaining to recognition of atrial isomerism. Consequences for sequential chamber localisation. Br Heart J 1980;44:657–667.CrossRefGoogle Scholar
11.Sharma, S, Devine, W, Anderson, RH, Zuberbuhler, JR. The determination of atrial arrangement by examination of appendage morphology in 1842 heart specimens. Br Heart J 1988;60:227–231.CrossRefGoogle ScholarPubMed
12.Uemura, H, HO, SY, Devine, WA, Anderson, RH. Atrial appendages and venottial connections in hearts with visceral heterotaxt Ann Thorac Surg 1995 60:561–569.CrossRefGoogle Scholar
13.Debich, DE, Devine, WA, Anderson, RH. Polysplenia with normally structured hearts. Am J Cardiol 1990;65:1274–1276.CrossRefGoogle ScholarPubMed
14.Anderson, C, Devine, WA, Anderson, RH, Debich, DE, Zuberbuhler, JR. Abnormalicies of the spleen in relation to congenital malformations of the heart: a survey of necropsy findings in children. Br Heart j 1990;63:122–128.CrossRefGoogle Scholar
15.Ven Praagh, R, David, I, Gordon, D, Wright, GB, Van Praagh, S. Ventricular diagnosis and designation. In: Godman, M (ed). Paediatric Cardiology Volume 4. Edinbursh: Churchill Livingstone. 1981; pp 153ndash;168.Google Scholar
16.Shinebourne, EA, Macartney, FJ, Anderson, RH. Sequential chamber localization - logical approach to diagnosis in congenital heart disease. Br Heart J 1976;38:327–340.CrossRefGoogle ScholarPubMed
17.Tynan, MJ, Becker, AE, Macartney, FJ, Quero-Jimenez, M, Shinebourne, EA, Anderson, RH. Nomenclature and classification of congenital heart disease. Br Heart J 1979;41:544–553.CrossRefGoogle ScholarPubMed
18.Anderson, RH, Becker, AE, Freedom, RM, Macartney, FJ, Quero-Jimenez, M, Shinebourne, EA, Wilkinson, JL, Tynan, MJ.Sequential segmental analysis of congenital heart disease. Pediatr Cardiol 1984; 5: 281–288.CrossRefGoogle ScholarPubMed
19.Anderson, RH, Smith, A, Wilkinson, JL.Disharmony between atrioventricular connexions and segmental combinations - unusual variants of “criss-cross” hearts. J Am Coll Cardiol 1987; 10: 1274–1277.CrossRefGoogle Scholar
20.Brandt, PWT. Cineangiocardiography of atrioventricular and ventriculo-arterial connexions. In: Godman, MJ (ed). Paediatric Cardiology Volume 4. Edinburgh: Churchill Livingstone 1981; pp 191–226.Google Scholar
21.Anderson, RH, Macartney, FJ, Tynan, M, Becker, AE, Freedom, RM, Godman, MJ, Hunter, S, Quero, Jimènez M, Rigby, ML, Shinebourne, EA, Sutherland, GR, Smallhorn, JF, Soto, B, Thiene, G, Wilkinson, JL, Wilcox, BR, Zuberbuhler, JR. Univentricular atrioventricular connection: the single ventricle trap unsprung. Pediatr Cardiol 1983; 4: 273–280.CrossRefGoogle ScholarPubMed