The Fate of the Outflow Tract Septal Complex in Relation to the Classification of Ventricular Septal Defects

Anderson, Robert H.; Tretter, Justin T.; Spicer, Diane E.; Mori, Shigeo

doi:10.3390/jcdd6010009

Cited by 11 publications

(25 citation statements)

References 15 publications

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“…The participation of the FHF and SHF with these structures has not been established, making the determination of homology with the septal structures in mammals hazardous. It is tempting to nominate the mammalian interventricular septum as the border between left and right ventricles based on the expression on FHF‐ and SHF‐related patterns; however, the evolution and development of the interventricular septum with its inlet (probably FHF‐derived) and folding (probably both FHF‐ and SHF‐derived) constituents is too complicated for this simplification . Further investigations determining the genetic networks in the septal complexes of reptiles, birds, and mammals are warranted before a more definitive conclusion can be drawn concerning the homology of the cava and ventricles and their separating myocardial and mesenchymal elements.…”

Section: Cardiac Septationmentioning

confidence: 99%

Development and evolution of the metazoan heart

Poelmann

Groot

2019

Developmental Dynamics

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The mechanisms of the evolution and development of the heart in metazoans are highlighted, starting with the evolutionary origin of the contractile cell, supposedly the precursor of cardiomyocytes. The last eukaryotic common ancestor is likely a combination of several cellular organisms containing their specific metabolic pathways and genetic signaling networks. During evolution, these tool kits diversified. Shared parts of these conserved tool kits act in the development and functioning of pumping hearts and open or closed circulations in such diverse species as arthropods, mollusks, and chordates. The genetic tool kits became more complex by gene duplications, addition of epigenetic modifications, influence of environmental factors, incorporation of viral genomes, cardiac changes necessitated by air‐breathing, and many others. We evaluate mechanisms involved in mollusks in the formation of three separate hearts and in arthropods in the formation of a tubular heart. A tubular heart is also present in embryonic stages of chordates, providing the septated four‐chambered heart, in birds and mammals passing through stages with first and second heart fields. The four‐chambered heart permits the formation of high‐pressure systemic and low‐pressure pulmonary circulation in birds and mammals, allowing for high metabolic rates and maintenance of body temperature. Crocodiles also have a (nearly) separated circulation, but their resting temperature conforms with the environment. We argue that endothermic ancestors lost the capacity to elevate their body temperature during evolution, resulting in ectothermic modern crocodilians. Finally, a clinically relevant paragraph reviews the occurrence of congenital cardiac malformations in humans as derailments of signaling pathways during embryonic development.

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Section: Cardiac Septationmentioning

confidence: 99%

Development and evolution of the metazoan heart

Poelmann

Groot

2019

Developmental Dynamics

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“…And, if development proceeds normally, the proximal outflow cushions, which themselves have formed the shelf in the roof of the right ventricle, become muscularised and remodelled, thus forming the free-standing subpulmonary infundibulum. 15 Only if development is incomplete, with the tertiary foramen persisting as a ventricular septal defect, do these myocardialised cushions persist as a muscular outlet septum.…”

Section: Developmental Considerationsmentioning

confidence: 99%

“…It is this feature that is diagnostic for the ventricular septal defects that are juxta-arterial. 15 The inference can also be made, on the basis of the development observed in the normal mice, and those suffering perturbation of the Furin enzyme, that either the perimembranous or juxta-arterial defects could co-exist with defects in the apical muscular part of the septum. It also follows that multiple individual defects might be anticipated to exist within the muscular septum, or that failure of coalescence could hav been sufficiently severe to produce the Swiss-cheese arrangement.…”

Section: Development Relative To the Variable Patterns Of Multiple Ventricular Septal Defectsmentioning

confidence: 99%

“…The group of defects reflect failure of closure of the tertiary interventricular communication. 15 Its phenotypic feature is fibrous continuity between the leaflets of the mitral and tricuspid valves (Figure 4B). 16 The defect incorporates within its borders the atrioventricular component of the membranous septum.…”

Section: The Phenotypic Features Of Multiple Ventricular Septal Defectsmentioning

confidence: 99%

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A Reassessment of the anatomical features of multiple ventricular septal defects

Spicer

Anderson

Chowdhury

et al. 2021

Preprint

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Over the course of time, new developments associated with embryogenesis of the murine heart have served to clarify the developmental processes observed in the human heart. This evidence allows for creation of a developmental framework for many congenital cardiac defects. Here, we aim to solidify the framework related to the categorization of both solitary and multiple ventricular septal defects. Mice having genetic perturbation of the Furin enzyme have demonstrated perimembranous and juxta-arterial ventricular septal defects, permitting the inference to be made that these defects can co-exist with defects occurring within the apical muscular septum. Based on developmental evidence, furthermore, all interventricular communications can be placed into one of three groups, namely, those which are perimembranous, juxta-arterial, and muscular. All of the defects are described based on their borders as seen from the morphologically right ventricle. Our focus here will be on those defects within the muscular ventricular septum, recognizing that such defects can co-exist with those that are perimembranous. We discuss the differentiation of multiple discrete defects from those referred to as the ‘Swiss cheese’ variant. As we show, appropriate surgical management requires understanding of the specific terminology, as the surgical approach may differ depending on the combination of the individual defects. Data from the Society for Thoracic Surgeons revealed that both mortality and morbidity were increased in the setting of multiple as opposed to solitary ventricular septal defects.

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“…Anomalies in cardiac outflow tract (OFT) are among the most frequent CHDs, with a prevalence of 30%, likely reflecting the complex morphogenetic events underlying heart development [ 1 , 2 ]. The cardiac OFT, comprised of the conus or bulbus cordis and the truncus arteriosus (together called the conotruncal region), is a rapidly remodeling structure during embryogenesis at the arterial pole of the heart, as it connects the embryonic ventricles to the aortic sac [ 3 ]. The OFT forms during heart looping from progenitor cells in splanchnic pharyngeal mesoderm.…”

Section: Introductionmentioning

confidence: 99%

Outflow Tract Formation—Embryonic Origins of Conotruncal Congenital Heart Disease

Stefanovic

Etchevers

Zaffran

2021

JCDD

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Anomalies in the cardiac outflow tract (OFT) are among the most frequent congenital heart defects (CHDs). During embryogenesis, the cardiac OFT is a dynamic structure at the arterial pole of the heart. Heart tube elongation occurs by addition of cells from pharyngeal, splanchnic mesoderm to both ends. These progenitor cells, termed the second heart field (SHF), were first identified twenty years ago as essential to the growth of the forming heart tube and major contributors to the OFT. Perturbation of SHF development results in common forms of CHDs, including anomalies of the great arteries. OFT development also depends on paracrine interactions between multiple cell types, including myocardial, endocardial and neural crest lineages. In this publication, dedicated to Professor Andriana Gittenberger-De Groot and her contributions to the field of cardiac development and CHDs, we review some of her pioneering studies of OFT development with particular interest in the diverse origins of the many cell types that contribute to the OFT. We also discuss the clinical implications of selected key findings for our understanding of the etiology of CHDs and particularly OFT malformations.

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The Fate of the Outflow Tract Septal Complex in Relation to the Classification of Ventricular Septal Defects

Cited by 11 publications

References 15 publications

Development and evolution of the metazoan heart

Development and evolution of the metazoan heart

A Reassessment of the anatomical features of multiple ventricular septal defects

Outflow Tract Formation—Embryonic Origins of Conotruncal Congenital Heart Disease

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