{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:48:46Z","timestamp":1792180126047,"version":"4.4.0"},"reference-count":14,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2019,2,21]],"date-time":"2019-02-21T00:00:00Z","timestamp":1550707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>It is now established that the entity often described as an \u201caortopulmonary septal complex\u201d is better considered as an \u201coutflow tract septal complex\u201d. This change is crucial for appropriate understanding of not only malformations of the outflow tract, but also ventricular septal defects. Thus, the embryonic outflow tract, as it develops, is separated into its two components by fusion of a protrusion from the dorsal wall of the aortic sac with the distal end of the outflow cushions. The key point with regard to morphogenesis is that, with ongoing development, these structures lose their septal integrity, although they can still be identified as septal structures when the ventricular septum itself is deficient. In the normal postnatal heart, however, the aortic and pulmonary components have their own walls throughout the length of the outflow tracts. All of this is of clinical significance, since some current concepts of categorisation of the ventricular septal defects are based on the existence in the normal heart of a \u201cconal septum\u201d, along with a \u201cseptum of the atrioventricular canal\u201d. In this review, we show how analysis of postnatal hearts reveals the definitive ventricular septum to possess only muscular and fibrous components in the absence of either discrete outflow or inlet components. We also show that this information regarding development, in turn, is of major significance in determining whether categorisation of ventricular septal defects is best approached, in the first instance, on the basis of the borders of the defects or the fashion in which they open to the right ventricle.<\/jats:p>","DOI":"10.3390\/jcdd6010009","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T03:49:44Z","timestamp":1550807384000},"page":"9","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Fate of the Outflow Tract Septal Complex in Relation to the Classification of Ventricular Septal Defects"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5163-9021","authenticated-orcid":false,"given":"Robert H.","family":"Anderson","sequence":"first","affiliation":[{"name":"Institute of Genetic Medicine, Newcastle University, Newcastle-upon-Tyne NE1 3BZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-3752","authenticated-orcid":false,"given":"Justin T.","family":"Tretter","sequence":"additional","affiliation":[{"name":"Heart Institute, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH 45229, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane E.","family":"Spicer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumpei","family":"Mori","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Poelmann, R.E., and Gittenberger-de Groot, A.C. (2018). Hemodynamics in cardiac development. J. Cardiovasc. Dev. Dis., 5.","DOI":"10.20944\/preprints201809.0313.v1"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1006\/dbio.1998.8860","article-title":"Cardiac neural crest cells provide new insight into septation of the cardiac outflow tract: Aortic sac to ventricular septal closure","volume":"196","author":"Waldo","year":"1998","journal-title":"Dev. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.athoracsur.2018.06.020","article-title":"Classification of Ventricular Septal Defects for the Eleventh Iteration of the International Classification of Diseases\u2014Striving for Consensus: A Report From the International Society for Nomenclature of Paediatric and Congenital Heart Disease","volume":"106","author":"Lopez","year":"2018","journal-title":"Ann. Thorac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Mori, S., Tretter, J.T., Spicer, D.E., and Anderson, R.H. (2019). What is the real cardiac anatomy?. Clin. Anat.","DOI":"10.1002\/ca.23340"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.gde.2011.07.004","article-title":"Imaging heart development using high-resolution episcopic microscopy","volume":"21","author":"Mohun","year":"2011","journal-title":"Curr. Opin. Genet. Dev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1016\/0735-1097(89)90431-2","article-title":"Ventricular septal defects: How shall we describe, name and classify them?","volume":"14","author":"Geva","year":"1989","journal-title":"J. Am. Coll. 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