Das Wesen der Transposition im Gebiete des Herzens, ein Versuch der Erklärung auf entwicklungsgeschichtlicher Grundlage

Abstract

Das erste grundlegende Werk, das sich mit der Erscheinung der Transposition, ihrer Einteilung und Erkl/~rung eingehend befagte, ging aus der Prosektur des Allgemeinen Krankenhauses in Wien hervor (Ro]citans/cy 1875). Der Umstand, dab das im Museum des path01ogisch-ana-

Formal genesis of the outflow tracts of the heart revisited: Previous works in the light of recent observations

“…The truncus, which is located between the aortic sac and conus, elongates downwards in an oblique sinistro-lateral direction, and joins with the cephalic portion of the conus (Figs 1d, 2a,b and 3a,b) (Okamoto et al 1978;Akimoto 1979). The boundary of the truncus and conus segments is marked by a distinct bend, which is described in the literature under a variety of names: distal Kinickung-Furche (Pernkopf and Wirtinger 1933), arbitrary divisional line (Kramer 1942), arbitrary limit (de la Cruz and Da Rochia 1956), knee (Grant 1962), bayonet bend (Laane 1978;Orts Llorca et al 1982), and dog-leg bend Webb et al 2003). It is considered that the conotruncal curvature contributes to avoiding regurgitation of the blood flow before the appearance of the arterial valves (Lamers and Moorman 2002).…”

“…Sixth, the condensed mesenchymal structure (aorticopulmonary septum), formed by cells derived from cardiac neural crest, separates the aortic sac and truncus (Waldo et al 1998;Kelly 2007). As mentioned above, the condensed mesenchyme (invagination of the dorsal wall of the aortic sac) has been called the following: 'a spur of mesenchymal tissue' (Los 1978), 'aortico-pulmonaler teilungssporen' (Pernkopf and Wirtinger 1933), 'horseshoe-shaped structure' (Sissman 1970a,b;Laane 1978;Icardo 1984), 'an inverted Y or U of condensed mesenchyme', 'rotation and retraction of the aorticopulmonary septation complex' Fitzharris 1979a,b, 1985;Waldo et al 1998), and 'an arch (main bolus) with two limbs (the extensions)' (Asami 1980). This tissue forms 'two limbs or arms' (ventral and dorsal prongs, or rods) (Bartelings et al 1986;Poelmann et al 1998;Epstein et al 2000;Jiang et al 2000;Kirby and Waldo 2002;Boot et al 2003).…”

“…Anderson et al (2003) implied that the cushions are continuous throughout the outflow tract, spiraling round one another as they run from the distal end of the right ventricle to the aortic sac. Rotation of the outflow tract and the concomitant spiraling of the truncus swellings and conus ridges are considered to contribute to the formation of normal alignment of the arterial trunks (Born 1889;Tandler 1912;Spitzer 1923;Pernkopf and Wirtinger 1933;Lev and Saphir 1937;Doerr 1950;Patten 1960;Goerttler 1963;Asami 1969;Bersch et al 1975;Van Praagh et al 1980;Van Praagh 1985;Lomonico et al 1986Lomonico et al , 1988Chuaqui 1990). Goor et al (1972) could not find evidence for the commonly accepted aorticopulmonary septum twist as it grows towards the conus septum, and they emphasized that once the aorticopulmonary septum and the truncus septum are fused, the truncus rotate about 90-110°in a counterclockwise rotation.…”

“…1978; Akimoto 1979). The boundary of the truncus and conus segments is marked by a distinct bend, which is described in the literature under a variety of names: distal Kinickung‐Furche (Pernkopf and Wirtinger 1933), arbitrary divisional line (Kramer 1942), arbitrary limit (de la Cruz and Da Rochia 1956), knee (Grant 1962), bayonet bend (Laane 1978; Orts Llorca et al . 1982), and dog‐leg bend (Anderson et al .…”

“…1998; Kelly 2007). As mentioned above, the condensed mesenchyme (invagination of the dorsal wall of the aortic sac) has been called the following: ‘a spur of mesenchymal tissue’ (Los 1978), ‘aortico‐pulmonaler teilungssporen’ (Pernkopf and Wirtinger 1933), ‘horseshoe‐shaped structure’ (Sissman 1970a,b; Laane 1978; Icardo 1984), ‘an inverted Y or U of condensed mesenchyme’, ‘rotation and retraction of the aorticopulmonary septation complex’ (Thompson and Fitzharris 1979a,b, 1985; Waldo et al . 1998), and ‘an arch (main bolus) with two limbs (the extensions)’ (Asami 1980).…”