The left/right (LR) axial pathway establishes asymmetry in the patterning and morphogenesis of multiple internal organs, including the heart. In mammals, this pathway involves the breaking of molecular symmetry in or around the node, transfer of asymmetry information to the lateral plate mesoderm (LPM), propagation of molecular asymmetries throughout the LPM, and interpretation of these signals for proper organ morphogenesis (Nonaka et al. 2002). Recent experiments have demonstrated that the breaking of bilateral symmetry in the mouse node occurs via a process termed "nodal flow," in which motile cilia in the node generate leftward movement of molecular determinants via lipoprotein vesicles (Hirokawa et al. 2006;. NODAL, a transforming growth factor  (TGF) superfamily member, is a key molecule in the LR cascade. NODAL acts first in mesoderm specification and anterior-posterior axis formation, signaling through a membrane complex containing type I and II TGF serine/ threonine kinase receptors, as well as GPI-anchored members of the EGF-CFC family. This complex phosphorylates intracellular SMAD2 and SMAD3, which associate with the common TGF/NODAL/BMP (bone morphogenetic protein) pathway SMAD, SMAD4, and forkhead transcription factor FOXH1, to regulate downstream target genes (Shen 2007). In the LR pathway,