The anatomy of cardiac looping: A step towards the understanding of the morphogenesis of several forms of congenital cardiac malformations
Article first published online: 25 JUL 2008
Copyright © 2008 Wiley-Liss, Inc.
Special Issue: Special Issue on Cardiac Anatomy
Volume 22, Issue 1, pages 21–35, January 2009
How to Cite
Männer, J. (2009), The anatomy of cardiac looping: A step towards the understanding of the morphogenesis of several forms of congenital cardiac malformations. Clin. Anat., 22: 21–35. doi: 10.1002/ca.20652
- Issue published online: 18 DEC 2008
- Article first published online: 25 JUL 2008
- Manuscript Accepted: 28 APR 2008
- Manuscript Revised: 21 APR 2008
- Manuscript Received: 14 DEC 2007
- heart development;
- congenital cardiac malfomations
The early embryonic heart of vertebrates is a simple tubular pump. During the early phases of its development, the initially straight embryonic heart tube becomes transformed into a helically wound loop that is normally seen with a counterclockwise winding. This process is named cardiac looping. Such looping not only establishes the basic type of topological left-right asymmetry of the ventricular chambers but, additionally, is also said to bring the segments of the heart tube and the developing great vessels into an approximation of their definitive topographical relationships. Cardiac looping is, therefore, regarded as the key process in cardiac morphogenesis and pathologists have speculated since the beginning of the 20th century that several forms of congenital cardiac malformations (e.g., with mirror-imaged arrangement of the ventricular chambers) might result from disturbances in looping morphogenesis. In this article a review is given on (1) differences in the usage of the term cardiac looping; (2) our current knowledge of the dynamically changing anatomy of the looping embryonic heart; and (3) our current knowledge of the role of looping anomalies in the morphogenesis of congenital cardiac malformations. Clin. Anat. 22:21–35, 2009. © 2008 Wiley-Liss, Inc.