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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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Last updated: February 3, 2026