Introduction to the Special Issue on Cardiac Anatomy

EDITORIALIntroduction to the Special Issueon Cardiac AnatomyThe cynical reader may well believe that all that needsto be known about the anatomy of the heart is alreadypresent in existing textbooks of parisonof the illustrations existing in most textbooks with theimages now being produced by clinicians using recentlydeveloped techniques such as computed tomography,magnetic resonance imaging,or three-dimensionalechocardiography shows that this is far from the case.In fact,much of the material in those textbooks areremarkably poorly suited for providing the backgroundinformation on cardiac structure required by the clini-cian.In part,this reflects the reluctance of thosedescribing cardiac structure to follow the basic rules ofhuman anatomy.It is well accepted that all structuresin the body are described on the basis of the so-calledanatomic position,with the subject standing uprightand facing the observer.Why is it,therefore,that gen-erations of those describing cardiac structure have bla-tantly ignored this convention,including in the past oneof the authors of this introduction(RHA),and insteadhave described the heart as seen when removed fromthe body and positioned on its own apex?This providessuitable correlation with the organ as depicted on thecards produced to celebrate St Valentine’s day,butdoes little to help the practising clinician,who increas-ingly is able to visualize all cardiac components in thedirect relationship to the thoracic and abdominal con-tents.And,if all is known about the structure of the heart, how can it be that some textbooks of general anatomy include descriptions of suchfictional structures as the ‘‘specialized internodal tracts,’’and the‘‘unique myocar-dial band?’’It remains a fact that the basic anatomical knowledge obtained by medical students comes from their initial experiences,which mercifully for the greater part includes ongoing studies of human anatomy as revealed by cadaveric dissection.It is incumbent upon those providing instruction for these students to be properly informed of the structure of the cardiac compo-nents,and their proper relationships to the bodily com-ponents.It is our hope that this special issue of Clinical Anatomy will provide all this necessary information.We are both sufficiently arrogant to believe that our own knowledge of cardiac structure,after detailed study of the heart over,in one instance a full career,and in the other instance half a career,is on a par with that of any other observer,that we have taken it upon ourselves, working with close colleagues,to provide the majority of the reviews included within the special issue.We are extremely grateful,nonetheless,that those who we asked to join us in producing‘‘cutting-edge’’reviews have lived up to their words.We are indebted,there-fore,to all these colleagues whose own work is included within these pages.Because the special issue is pub-lished by Clinical Anatomy,we asked all our colleagues to stress the clinical significance of theirfindings.We believe that they have been remarkably successful in achieving this goal.We hope that our own contributions are as clinically focused as those provided by our friends and colleagues.In all instances,nonetheless,the edito-rial team responsible for the content of the journal were fastidious in ensuring that own contributions also under-went the full gamut of rigorous peer review.We can assure all our readers that the comments of ourrefer-Dr.Loukas and Dr.Anderson during the Advance of Knowledge in Cardiac Morphology and Development course organized by Dr.Anderson in2007in London, UK.*Correspondence to:Marios Loukas M.D.,Ph.D.,Department of Anatomical Sciences,St George’s University,School of Medicine, Grenada,West Indies.E-mail:mloukas@Received19November2008;Accepted22November2008 Published online17December2008in Wiley InterScience(www. ).DOI10.1002/ca.20762V C2008Wiley-Liss,Inc.Clinical Anatomy22:2–3(2009)ees were stringent and appropriate.Thus,it is our belief that the special issue you now hold contains most of what is required by the budding cardiologist or cardiac surgeon to become up-to-date with the clinical anatomy of the heart.Should there still be deficiencies,they are entirely our responsibility.We are ready to respond in appropriate fashion to correct any such faults.We hope you enjoy reading the issue as much as we enjoyed producing it.Robert H.Anderson Division of Pediatric CardiologyDepartment of Pediatrics Medical University of South CarolinaCharleston,South CarolinaMarios Loukas* Department of Anatomical SciencesSchool of MedicineSt.George’s UniversityGrenada,West Indies3 Special Issue on Cardiac Anatomy。