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Insights regarding the normal and abnormal formation of the atrial and ventricular septal structures

Lookup NU author(s): Professor Bob Anderson


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Knowledge of cardiac development can provide the basis for understanding the morphogenesis of congenital cardiac malformations. Only recently, however, has the quality of information regarding cardiac embryology been sufficient to justify this approach. In this review, we show how such knowledge of development of the normal atrial and ventricular septal structures underscores the interpretation of the lesions that provide the basis for interatrial and interventricular shunting of blood. We show that current concepts of atrial septation, which frequently depend on a suggested formation of an extensive secondary septum, are simplistic. There are additional contributions beyond growth of the primary septum, but the new tissue is added to form the ventral buttress of the definitive atrial septum, rather than its cranial margin, as is usually depicted. We show that the ventricular septum possesses muscular and membranous components, with the entirety of the muscular septum produced concomitant with the so-called ballooning of the apical ventricular component. It is expansion of the atrioventricular canal that creates the inlet of the right ventricle, with no separate formation of an inlet septum. The proximal parts of the outflow cushions initially form a septal structure between the developing ventricular outlets, but this becomes converted into the free-standing muscular subpulmonary infundibulum as the aortic outlet is transferred to the left ventricle. These features of normal development are then shown to provide the basis for understanding of the channels that provide the means for interatrial and interventricular shunting. Clin. Anat. 29:290-304, 2016. (c) 2015 Wiley Periodicals, Inc.

Publication metadata

Author(s): Anderson RH, Brown NA, Mohun TJ

Publication type: Review

Publication status: Published

Journal: Clinical Anatomy

Year: 2016

Volume: 29

Issue: 3

Pages: 290-304

Print publication date: 01/04/2016

Online publication date: 07/10/2015

Acceptance date: 11/09/2015

ISSN (print): 0897-3806

ISSN (electronic): 1098-2353



DOI: 10.1002/ca.22627