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. 1979 Apr;41(4):481–485. doi: 10.1136/hrt.41.4.481

Doerr's theory of morphogenesis of arterial transposition in light of recent research.

B Chuaqui
PMCID: PMC482057  PMID: 465216

Abstract

Doerr's theory of the morphogenesis of transposition is discussed with special reference to recent studies by Goor and co-workers and Anderson and associates. The views advanced by all these authors coincide in three points: (a) the description of the reorganisation process occurring at the arterial end of the embryonic heart (a process called by Doerr vectorial bulbus rotation); (b) the pathogenetic interpretation of transposition as the result of an arrest of vectorial bulbus rotation; (c) the recognition of a teratological series or spectrum of anomalies pathogenetically related to transposition. Vectorial bulbus rotation is explained mainly as the result of three largely simultaneous events; bulbar shift, bulbus torsion, and truncus torsion. The spectrum of anomalies related to transposition appears as a close-knit series. Bulbar retraction does not seem to be a necessary condition for the connection of the aorta to the left ventricle.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson R. H., Wilkinson J. L., Arnold R., Becker A. E., Lubkiewicz K. Morphogenesis of bulboventricular malformations. II. Observations on malformed hearts. Br Heart J. 1974 Oct;36(10):948–970. doi: 10.1136/hrt.36.10.948. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Anderson R. H., Wilkinson J. L., Arnold R., Lubkiewicz K. Morphogenesis of bulboventricular malformations. I. Consideration of embryogenesis in the normal heart. Br Heart J. 1974 Mar;36(3):242–255. doi: 10.1136/hrt.36.3.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Asami I. Beitrag zur Entwicklung des Kammerseptums im menschlichen Herzen mit besonderer Berücksichtigung der sogenannten Bulbusdrehung. Z Anat Entwicklungsgesch. 1969;128(1):1–17. [PubMed] [Google Scholar]
  4. BEUREN A. Differential diagnosis of the Taussig-Bing heart from complete transposition of the great vessels with a posteriorly overriding pulmonary artery. Circulation. 1960 Jun;21:1071–1087. doi: 10.1161/01.cir.21.6.1071. [DOI] [PubMed] [Google Scholar]
  5. Becker A. E., Connor M., Anderson R. H. Tetralogy of Fallot: a morphometric and geometric study. Am J Cardiol. 1975 Mar;35(3):402–412. doi: 10.1016/0002-9149(75)90034-x. [DOI] [PubMed] [Google Scholar]
  6. Bersch W., Chuaqui B., Heilmann K. Persistenz des primitiven Aortenconus bei regelrechter Stellung der grossen des Herzens. Ein Beitrag zur formalen Eigenständigkeit der Bulbusschrumpfungshemmung. Virchows Arch A Pathol Anat Histol. 1975 Nov 28;368(4):299–307. doi: 10.1007/BF00432308. [DOI] [PubMed] [Google Scholar]
  7. Chuaqui B., Bersch W. The formal genesis of the transposition of the great arteries. Virchows Arch A Pathol Pathol Anat. 1973;358(1):11–34. doi: 10.1007/BF00555551. [DOI] [PubMed] [Google Scholar]
  8. Chuaqui B., Bersch W. The periods of determination of cardiac malformations. Virchows Arch A Pathol Pathol Anat. 1972;356(2):95–110. doi: 10.1007/BF00549282. [DOI] [PubMed] [Google Scholar]
  9. Chuaqui B. Uber die Dextropositio aortae (Bemerkungen zur Affassung von H. Bankl. Beitr Pathol. 1971;144(4):394–399. [PubMed] [Google Scholar]
  10. DE LA CRUZ M. V., ANSELMI G., CISNEROS F., REINHOLD M., PORTILLO B., ESPINO-VELA J. An embryologic explanation for the corrected transposition of the great vessels: additional description of the main anatomic features of this malformation and its varieties. Am Heart J. 1959 Jan;57(1):104–117. doi: 10.1016/0002-8703(59)90360-6. [DOI] [PubMed] [Google Scholar]
  11. DE LA CRUZ M. V., DA ROCHA J. P. An ontogenetic theory for the explanation of congenital malformations involving the truncus and conus. Am Heart J. 1956 May;51(5):782–805. doi: 10.1016/s0002-8703(56)80013-6. [DOI] [PubMed] [Google Scholar]
  12. DOERR W. Die formale Entstehung der wichtigsten Missbildungen des arteriellen Herzendes; Eisenmenger-, Fallots-, Taussig-Bing-Komplex, Transposition. Beitr Pathol Anat. 1955;115(1):1–32. [PubMed] [Google Scholar]
  13. DOERR W. Uber ein formales Prinzip der Koppelung von Entwicklungsstörungen der venösen und arteriellen Kammerostien. Z Kreislaufforsch. 1952 Apr;41(7-8):269–284. [PubMed] [Google Scholar]
  14. De la Cruz M. V., Anselmi G., Munos-Castellanos L., Nadal-Ginard B., Munoz-Armas S. Systematization and embryological and anatomical study of mirror-image dextrocardias, dextroversions, and laevoversions. Br Heart J. 1971 Nov;33(6):841–853. doi: 10.1136/hrt.33.6.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. De la Cruz M. V., Espino-Vela J., Attie F., Muñoz L. An embryologic theory for ventricular inversions and their classification. Am Heart J. 1967 Jun;73(6):777–793. doi: 10.1016/0002-8703(67)90229-3. [DOI] [PubMed] [Google Scholar]
  16. Gessner I. H. Spectrum of congenital cardiac anomalies produced in chick embryos by mechanical interference with cardiogenesis. Circ Res. 1966 Jun;18(6):625–633. doi: 10.1161/01.res.18.6.625. [DOI] [PubMed] [Google Scholar]
  17. Goor D. A., Dische R., Lillehei C. W. The conotruncus. I. Its normal inversion and conus absorption. Circulation. 1972 Aug;46(2):375–384. doi: 10.1161/01.cir.46.2.375. [DOI] [PubMed] [Google Scholar]
  18. Goor D. A., Edwards J. E., Lillehei C. W. The development of the interventricular septum of the human heart; correlative morphogenetic study. Chest. 1970 Nov;58(5):453–467. doi: 10.1378/chest.58.5.453. [DOI] [PubMed] [Google Scholar]
  19. Goor D. A., Edwards J. E. The conotruncus. II. Report of a case showing persistent aortic conus and lack of inversion of the truncus (a bulboventricular heart). Circulation. 1972 Aug;46(2):385–389. doi: 10.1161/01.cir.46.2.385. [DOI] [PubMed] [Google Scholar]
  20. Goor D. A., Edwards J. E. The spectrum of transposition of the great arteries: with specific reference to developmental anatomy of the conus. Circulation. 1973 Aug;48(2):406–415. doi: 10.1161/01.cir.48.2.406. [DOI] [PubMed] [Google Scholar]
  21. Lev M., Bharati S., Meng C. C., Liberthson R. R., Paul M. H., Idriss F. A concept of double-outlet right ventricle. J Thorac Cardiovasc Surg. 1972 Aug;64(2):271–281. [PubMed] [Google Scholar]
  22. Macartney F. J., Shinebourne E. A., Anderson R. H. Editorial: Connexions, relations, discordance, and distorsions. Br Heart J. 1976 Apr;38(4):323–326. doi: 10.1136/hrt.38.4.323. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. NEILL C. A. Development of the pulmonary veins; with reference to the embryology of anomalies of pulmonary venous return. Pediatrics. 1956 Dec;18(6):880–887. [PubMed] [Google Scholar]
  24. O'Rahilly R. The timing and sequence of events in human cardiogenesis. Acta Anat (Basel) 1971;79(1):70–75. doi: 10.1159/000143625. [DOI] [PubMed] [Google Scholar]
  25. Patterson D. F., Pyle R. L., Van Mierop L., Melbin J., Olson M. Hereditary defects of the conotruncal septum in Keeshond dogs: pathologic and genetic studies. Am J Cardiol. 1974 Aug;34(2):187–205. doi: 10.1016/0002-9149(74)90198-2. [DOI] [PubMed] [Google Scholar]
  26. Rosenquist G. C., Clark E. B., Sweeney L. J., McAllister H. A. The normal spectrum of mitral and aortic valve discontinuity. Circulation. 1976 Aug;54(2):298–301. doi: 10.1161/01.cir.54.2.298. [DOI] [PubMed] [Google Scholar]
  27. Van Praagh R., Perez-Trevino C., Lõpez-Cuellar M., Baker F. W., Zuberbuhler J. R., Quero M., Perez V. M., Moreno F., Van Praagh S. Transposition of the great arteries with posterior aorta, anterior pulmonary artery, subpulmonary conus and fibrous continuity between aortic and atrioventricular valves. Am J Cardiol. 1971 Dec;28(6):621–631. doi: 10.1016/0002-9149(71)90049-x. [DOI] [PubMed] [Google Scholar]
  28. Van Praagh R., Van Praagh S. Anatomically corrected transposition of the great arteries. Br Heart J. 1967 Jan;29(1):112–119. doi: 10.1136/hrt.29.1.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Van Praagh R., Van Praagh S. Isolated ventricular inversion. A consideration of the morphogenesis, definition and diagnosis of nontransposed and transposed great arteries. Am J Cardiol. 1966 Mar;17(3):395–406. doi: 10.1016/0002-9149(66)90222-0. [DOI] [PubMed] [Google Scholar]

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