ABSTRACT
Knowledge of detailed cardiac anatomy is a prerequisite for successful surgery. Nowhere is this more important than in the setting of congenital cardiac malformations. Although the anatomy displayed in these anomalies is often complex, it is not necessarily difficult to understand. In this chapter, we describe the basic rules of cardiac anatomy, which permit the surgeon, working in the operating room, to diagnose and recognize the arrangement of the cardiac chambers. As we will show, this knowledge, at the same time, will provide guidelines to the position of the vital conduction tissues. The basic layout of the heart should, of course, be established prior to commencement of intracardiac procedures. The diagnosis of even the most complex cases demands, in the first instance, no more than the distinction, in terms of morphology, of a right atrium from a left atrium, a right ventricle from a left ventricle, and an aorta from a pulmonary trunk. Distinction of these various chambers and vessels then provides the basis of the approach for simple sequential segmental analysis. The anatomy of “holes” and “stenoses” and so on are of equal, or even greater, significance. This morphology will be described in the appropriate chapters. Here we are concerned specifically with setting the ground rules for a systematic approach to cardiac anatomy.
