The relationship between Aorta & PA is the key to diagnose many complex congenital heart diseases. Here is a simplified illustration for gross understanding. Please refer to other sources for complete review.


Further reading
Posted in congenital heart disease, Embryology : Heart valve development, embryology of heart, Uncategorized, tagged accessorry av node, Aorta pulmonary artery relationship, atrial septostomy, double switch surgery, dtgv ltgv ctgv, embryology of heart, left av valve regurgitation, ltgv ctgv in situs inversus LDD, rv lv function in ctgv ltgv, senning surgery, spiral septum, three letter code for chd, ventricular inversion on June 12, 2021|
Posted in Cardiology - Electrophysiology -Pacemaker, cardiology -congenital heart disease, cardiology-Anatomy, tagged accessary pathway, av node development, av node embryology, av ring and av node, circualtion research, circulation research, delta wave genesis, ectopic av nodal tissue, embryology of heart, wolf parkinson white syndrome, wpw syndrome on December 30, 2011| Leave a Comment »
Most cardiologists are familiar with “Circulation” . We know it is a top cardiology journal with highest impact factor. Few of us are aware of a journal called “Circulation research” ( I wonder why it is named like that , as if the regular circulation journal does not carry research stuff !)
It is one of the path breaking journals that regularly churn out state of the art , often mind boggling research stuff. Once in while we should get a feel of basic science research as it happens.
How else we are going to know an atrial cell is to be bio engineered shortly to behave like a SA node in patients with sinus node dysfunction. (Biological pacing )
This team from academic medical centre Amsterdam should be credited for publishing this gem of an article from a study involving the measly mice !
It deals elaborately about the embryonic basis of AV nodal disorders . Specifically it explains the genesis of WPW syndrome and how AV rings get muscularised .
(It is due to error in bio-genetic forces ,which affect the incorporation of AV nodal tissue in the fibrous skeleton .This results in ectopic junctional tissues appear any where along the AV ring . This is the basis of accessory AV pathway and clinical re-excitation.)
Final message
Once in a while we should develop the habit of reading tough journals like circulation research . After all , if a cardiologist is not reading these stuff who else . . . will ?
Reference
http://circres.ahajournals.org/content/107/6/728.full.pdf+html
Posted in Uncategorized, tagged asd vsd pda, bio geneitic forces, clarkes classification of chd, congenital heart disease, development of heart, embryology of heart, tissue mogration defect on July 18, 2010| Leave a Comment »
Life is nothing , but the intervening time between the first heart beat and the last heart beat of an individual !
Human heart is not an ordinary organ. Right from the day 22 of fetal life , when the cardiac jelly begins to beat till the early new-born period , (In some, even longer !) it continues to evolve.
We know heart as a hemodynamic organ . But , in the fetus it is dynamic in a different sense (Embryo-dynamics) . As the mother’s heart takes care of the fetal circulation , the fetal heart concentrates on it ‘s own growth .The heart learns the lessons of life in a hard way , it has to survive the next 70 -80 years independently .
The complexity is enormous . The cardiac muscle comes from mesenchyme, the conducting system comes from ectoderm .Systematic events like , looping , partition , regression of the heart tube should occur at critical times . Apart from this , the venous and arterial connections ( Aorta IVC,SVC) develop concomitantly and has to fuse with respective chambers without any error.
It is a wonderful biological marvel happening inside every fetus without the help of any architect !
The changes do not stop at birth. It continues , well after delivery . One hole gets closed(PFO), one conduit disappears (PDA) .One chamber regress (RV) . We, expect all these things to happen in a meticulous and sequential way.
Yes , it happens in most. But , in many with altered bio – genetic forces things fail to unfold in the programmed way. It is not at all a surprise , to find some common aberration .
So , when some body is born with a congenital heart defect , don’t blame it on God .He does his job , in billions and billions of heart in the right manner .
It is our ancestral gene code that gets awry in a few !
In Hindu philosophy the defects we inherit are the wages we pay for our ancestral misdeeds .