Anatomy for Pediatric and Congenital Cardiac Surgery

Diane E. Spicer, BS, PA(ASCP)CM , Robert H. Anderson, MD

Key Points

The morphological method of anatomical analysis provides a standardized foundation for analyzing both normal and congenitally malformed hearts by defining cardiac components according to their most constant anatomic features, rather than variable connections or functions. Sequential segmental analysis applies the morphological method systematically, examining the atrial chambers, ventricular mass, and arterial trunks in sequence, with particular emphasis on variations across the atrioventricular and ventriculo-arterial junctions. Ventricular septal defects are best classified by their borders as seen from the morphologically right ventricle, allowing distinction among muscular, juxta-arterial, and perimembranous defects, each with predictable relationships to the atrioventricular conduction axis that are critical for surgical planning. Septal malalignment alters the course and origin for the conduction system, particularly in perimembranous defects with straddling or overriding atrioventricular valves; careful morphological analysis prevents misclassification and guides safe surgical repair.

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