Anatomy for Pediatric and Congenital Cardiac Surgery

Diane E. Spicer, BS, PA(ASCP)CM , Robert H. Anderson, MD


In this chapter, we set out a logical method for approaching cardiac anatomy, which relates both to the normal heart and the heart with complex congenital malformations. Detailed anatomic knowledge is important to the surgeon and the clinician alike. Use of a standardized system is the best way logically to approach the normal, and the congenitally malformed heart. The morphologic method, and the logic it infuses into sequential segmental analysis, allows for this standardized approach. We review the morphologic characteristics of each segment of the heart, namely, the atriums, the ventricles and the arterial trunks. We then provided additional information on how the components of the segments might or might not be connected. We emphasise the significance of the atrioventricular and ventriculo-arterial junctions, which are discrete anatomic boundaries. It is recognition of the variations that can occur across the junction that is the key to successful sequential segmental analysis. Attention to the anatomic features of the interatrial folds, along with the true components of the atrial septum and ventricular septum in the normal heart, adds credence to the description of defects involving these areas. As we emphasise, it is knowledge of the normal anatomy of the junctions and the arterial trunks that also provides a basis for describing the associated malformations. We conclude by providing a brief review of the salient anatomy of septal defects. We suggest that, when following our proposed systematic approach, the process of analysis can itself readily be standardized, thus proving its value even in hearts with the most complex malformations.

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Last updated: April 21, 2021