Sequential segmental analysis - description and categorization for the millennium

The concept of sequential analysis of congenitally malformed hearts is now widely accepted, although some aspects remain controversial. In this review, we analyse the evolution of the segmental approach, showing how our own concepts of analysis have changed little since our initial description, although improvements have been made in the words used for description. The. anatomic structure of the heart dictates the presence of the atrial, ventricular, and arterial segments. Analysis depends upon recognizing the morphologic differences of the components within each segment, and then how these parts are joined together across the atrioventricular and ventriculo-arterial junctions. The distinction of chambers and arterial trunks follows the principle of the morphologic method, namely that structures be identified on the basis of their own intrinsic morphology, and not according to other features which themselves might be variable. Differentiation of junctional arrangements as opposed to segmental structure resolves ongoing controversies such as the nature of ''univentricular hearts''. Analysis in the fashion proposed shows that there is nothing intrinsically complicated with malformed hearts.