Tetralogy of Fallot: nosological, morphological, and morphogenetic considerations
- 1 December 2013
- journal article
- review article
- Published by Cambridge University Press (CUP) in Cardiology in the Young
- Vol. 23 (6), 858-866
- https://doi.org/10.1017/s1047951113001686
Abstract
It is timely, in the 125th anniversary of the initial description by Fallot of the hearts most frequently seen in patients presenting with “la maladie bleu”, that we revisit his descriptions, and discuss his findings in the light of ongoing controversies. Fallot described three hearts in his initial publication, and pointed to the same tetralogy of morphological features that we recognise today, namely, an interventricular communication, biventricular connection of the aorta, subpulmonary stenosis, and right ventricular hypertrophy. In one of the hearts, he noted that the aorta arose exclusively from the right ventricle. In other words, one of his initial cases exhibited double-outlet right ventricle. When we now compare findings in hearts with the features of the tetralogy, we can observe significant variations in the nature of the borders of the plane of deficient ventricular septation when viewed from the aspect of the right ventricle. We also find that this plane, usually described as the ventricular septal defect, is not the same as the geometric plane separating the cavities of the right and left ventricles. This means that the latter plane, the interventricular communication, is not necessarily the same as the ventricular septal defect. We are now able to provide further insights into these features by examining hearts prepared from developing mice. Additional molecular investigations will be required, however, to uncover the mechanisms responsible for producing the morphological changes underscoring tetralogy of Fallot.Keywords
This publication has 10 references indexed in Scilit:
- Imaging heart development using high-resolution episcopic microscopyCurrent Opinion in Genetics & Development, 2011
- The clinical anatomy of tetralogy of FallotCardiology in the Young, 2005
- Anatomy of the muscular subpulmonary infundibulum with regard to the Ross procedureThe Annals of Thoracic Surgery, 2000
- Variations within the fibrous skeleton and ventricular outflow tracts in tetralogy of FallotThe Annals of Thoracic Surgery, 1990
- Etienne-Louis Arthur Fallot and his tetralogy: a new translation of Fallot's summary and a modern reassessment of this anomalyEuropean Journal of Cardio-Thoracic Surgery, 1989
- The cross sectional anatomy of ventricular septal defects: a reappraisal.Heart, 1988
- Tetralogy of Fallot: the centenary of the nameEuropean Journal of Cardio-Thoracic Surgery, 1988
- What should we call the 'crista'?Heart, 1977
- Tetralogy of fallot: A morphometric and geometric studyThe American Journal of Cardiology, 1975
- Tetralogy of fallot: Underdevelopment of the pulmonary infundibulum and its sequelaeThe American Journal of Cardiology, 1970