Doerr's theory of morphogenesis of arterial transposition in light of recent research

Abstract

Doerr's theory of the morphogenesis of transposition is discussed with special reference to recent studies by Goor and co-workers and Anderson and associates. The views advanced by all these authors coincide in three points: (a) the description of the reorganisation process occurring at the arterial end of the embryonic heart (a process called by Doerr vectorial bulbus rotation); (b) the pathogenetic interpretation of transposition as the result of an arrest of vectorial bulbus rotation; (c) the recognition of a teratological series or spectrum of anomalies pathogenetically related to transposition. Vectorial bulbus rotation is explained mainly as the result of three largely simultaneous events; bulbar shift, bulbus torsion, and truncus torsion. The spectrum of anomalies related to transposition appears as a close-knit series. Bulbar retraction does not seem to be a necessary condition for the connection of the aorta to the left ventricle.