Classification of a collection of malformed human hearts: practical experience in the use of sequential segmental...

The inauguration of Sequential Segmental Analysis (SSA) a few decades ago provides basic conditions to establish a universally applicable classification system for cardiac malformations. To gain practical experience, we used this method to classify a collection of 292 congenitally malformed human hearts. Our aims were to determine advantages and problems of the SSA and to make recommendations for a better practical usability and documentation. SSA is an appropriate instrument for the description of complex cardiac malformations because it is a logical step-by-step approach based on the heart morphology. The method optimizes the diagnosis of different malformed hearts. However, there are some disadvantages of SSA concerning terminology, localization of simple septal defects and exact topographic description of heart structures. For these reasons, we recommend a graphic description of the malformed heart using symbols based on the SSA. The most important prerequisite for an interdisciplinary acceptable classification system of cardiac malformations is to include morphological as well as functional aspects of the hearts.