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Lookup NU author(s): Professor Bob Anderson
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© Cambridge University Press 2017. It has long been contentious as to whether the presence of bilateral infundibulums, or conuses, is a prerequisite for the diagnosis of double-outlet right ventricle. As the use of such a criterion would abrogate the so-called morphological method, which correctly states that one variable entity should not be defined on the basis of another entity that is itself variable, it is now accepted that double outlet can exist in the setting of fibrous continuity between the leaflets of the atrioventricular and arterial valves. Although this debate has now been resolved, there are other contentious areas still requiring clarification in the setting of hearts unified because of the presence of this particular ventriculo-arterial connection - for example, it is questionable whether the channel between the ventricles should be described as a ventricular septal defect, whereas it is equally arguable that the mere presence of fibrous continuity between the leaflets of the arterial valves does not necessarily place the channel in a doubly committed location. In this review, we describe a series of autopsied hearts in which the anatomical features serve to illuminate these various topics. We then discuss recent findings regarding cardiac development that point to the individuality of the building blocks of the ventricular outflow tracts, specifically the outlet septum, the inner heart curvature, or ventriculo-infundibular fold, and the septomarginal trabeculation, or septal band.
Author(s): Aiello VD, Spicer DE, Anderson RH, Brown NA, Mohun TJ
Publication type: Review
Publication status: Published
Journal: Cardiology in the Young
Year: 2017
Volume: 27
Issue: 5
Pages: 825-836
Print publication date: 01/07/2017
Online publication date: 27/03/2017
Acceptance date: 13/02/2017
ISSN (print): 1047-9511
ISSN (electronic): 1467-1107
Publisher: Cambridge University Press
URL: https://doi.org/10.1017/S1047951117000452
DOI: 10.1017/S1047951117000452
