Virtual imaging for teaching cardiac embryology.

Knowledge of the embryology of the normal heart is essential for understanding the development of congenital cardiopathies. However, learning embryology is not an easy matter because it requires understanding the intricacy and evolution of many complex structures and functions. Classically, this evolution is usually described in textbooks by means of drawings and sketches. With these techniques, however, it is difficult to imagine the spatial and temporal links. Recent advances in computer graphics have brought about ways to illustrate these dimensions. We developed a 3D animation of the full embryogenetic process of the normal heart. A group of cardiac embryology experts composed of cardiologists, paediatrician-cardiologists, and embryologists synthesized the data contained in the main textbooks of embryology. On the basis of the resultant consensus, computer graphics were used to model 3D anatomical structures corresponding to each stage of heart development: fertilization, development of trilaminar germ disc, formation and folding of the primitive heart tube (Figure, A), morphogenesis of the heart chambers (Figure, B and C) and valves, and development of the aorta and the pulmonary artery (Figure, C). These illustrations demonstrate that virtual imaging can significantly improve the understanding of complex systems. It is now possible to understand normal heart development in 15 minutes.