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The morphological etiology of TGA is an inverted or arrested rotation of the heart outflow tract (OFT, conotruncus), by which the aorta is transposed in the right ventral direction to the pulmonary trunk. The rotational defect of the OFT is thought to be attributed to hypoplasia of the subpulmonic conus, which originates from the left anterior heart field (AHF) residing in the mesodermal core of the first and second pharyngeal arches. AHF, especially on the left, at the early looped heart stage (corresponding to Carnegie stage 10\u201311 in the human embryo) is one of the regions responsible for the impediment that causes TGA morphology. In human or experimentally produced right isomerism, malposition of the great arteries including D\u2010TGA is frequently associated. Mutations in genes involving left\u2013right (L\u2013R) asymmetry, such as <jats:italic>NODAL<\/jats:italic>, <jats:italic>ACTRIIB<\/jats:italic> and downstream target <jats:italic>FOXH1<\/jats:italic>, have been found in patients with right isomerism as well as in isolated TGA. The downstream pathways of Nodal\u2010Foxh1 play a critical role not only in L\u2013R determination in the lateral plate mesoderm but also in myocardial specification and differentiation in the AHF, suggesting that TGA is a phenotype in heterotaxia as well as the primary developmental defect of the AHF.<\/jats:p>","DOI":"10.1111\/cga.12176","type":"journal-article","created":{"date-parts":[[2016,6,22]],"date-time":"2016-06-22T19:34:51Z","timestamp":1466624091000},"page":"196-202","source":"Crossref","is-referenced-by-count":12,"title":["Mechanism responsible for D\u2010transposition of the great arteries: Is this part of the spectrum of right isomerism?"],"prefix":"10.1111","volume":"56","author":[{"given":"Yuji","family":"Nakajima","sequence":"first","affiliation":[{"name":"Department of Anatomy and Cell Biology, Graduate School of Medicine Osaka City University  Osaka 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