Bartelings M M, Gittenberger-de Groot A C
Department of Anatomy and Embryology, University of Leiden, The Netherlands.
Int J Cardiol. 1991 Oct;33(1):5-26. doi: 10.1016/0167-5273(91)90147-h.
On the basis of our recent embryologic work concerning the separation process of the outflow tract, our study of the morphology of specimens from the Leiden Collection of malformed hearts, and in conjunction with our review of the literature, we have reconsidered the morphogenesis of complete transposition and double outlet right ventricle. In complete transposition, a mirror-image arrangement of the columns of the aorto-pulmonary septum could explain the discordant ventriculo-arterial connexion and might thus play a role in its development. Dedicating a cardinal role to the aorto-pulmonary septum in the morphogenesis of complete transposition does not, however, seem justified. Double outlet right ventricle is not an embryologic entity. From the stance of the embryologist, we prefer to consider double outlet right ventricle in terms of a feature that may occur in specimens related to hearts with either a concordant ventriculo-arterial connexion (such as tetralogy of Fallot, or the so-called Eisenmenger ventricular septal defect), or a discordant ventriculo-arterial connexion (complete transposition).
基于我们近期有关流出道分隔过程的胚胎学研究、对来自莱顿畸形心脏标本库的标本形态学研究，并结合我们对文献的回顾，我们重新审视了完全性大动脉转位和右心室双出口的形态发生。在完全性大动脉转位中，主肺动脉隔柱的镜像排列可以解释心室-动脉连接不一致，因此可能在其发育中起作用。然而，认为主肺动脉隔在完全性大动脉转位的形态发生中起主要作用似乎并不合理。右心室双出口并非一个胚胎学实体。从胚胎学家的角度来看，我们更倾向于将右心室双出口视为一种可能出现在心室-动脉连接一致（如法洛四联症或所谓的艾森曼格室间隔缺损）或心室-动脉连接不一致（完全性大动脉转位）的心脏标本中的特征。
