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(Circulation. 1995;92:156-157.)
© 1995 American Heart Association, Inc.

Articles

Two Hearts That Beat as One

Magdi H. Yacoub, FRCS

From the National Heart and Lung Institute, Harefield and Royal Brompton Hospitals, Harefield, Uxbridge, Middlesex, England.

Correspondence to Sir Magdi Yacoub, FRCS, British Heart Foundation Professor of Cardiothoracic Surgery, National Heart and Lung Institute, Harefield and Royal Brompton Hospitals, Harefield, Uxbridge, Middlesex, UK UB9 6JH.

Key Words: ventricles • Editorials • imaging • Fontan procedure • transposition of the great arteries

	Introduction

 
"Two souls with but a single thought, two hearts that beat as one" Maria Lovall (1803-1877), Ingomar the Barbarian

Although the right and left ventricles develop from the same primitive heart tube during morphogenesis, they evolve into two relatively independent structures with so many different characteristics that with some justification they may be regarded as two different organs. Despite that, they are closely linked physically, mechanically, and electrically and appear to "beat as one." This intimate ventricular–ventricular relation is believed to have important functional implications during physiological and pathological states.^{1 2 3 4 5 6} The article by Fogel and colleagues in this issue of Circulation is a welcome addition to the literature, as it addresses certain aspects of ventricular–ventricular interaction and raises many issues relating to the similarities and differences between the two ventricles, including an instantaneous pattern of wall motion as defined by new imaging techniques, their relation to congenital abnormalities, and different forms of semicorrective operations with resultant adaptation, remodeling, and/or damage.

The shape of each ventricle is genetically determined to suit its exact function.⁷ Thus, the left ventricle is "flask" shaped with the inlet and outlet sharing one orifice. This enables the ventricle to deliver a bolus of blood against high resistance.

In contrast, the right ventricle consists of a flattened tube wrapped around the left ventricle with separate inlet and outlet orifices and a presumed contraction pattern simulating peristalsis. Such an arrangement is suited for pumping blood against low resistance. The fiber orientation and internal organization of each ventricle result . . . [Full Text of this Article]

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