**6. Acknowledgement**

We are indebted to all our colleagues in Taiwan who contributed or help to earlier studies establishing the concepts of our ideas in congenitally malformed hearts. We are grateful to Miss Chang-Ying Lin for the preparation of Figures. This study was supported by a grant from the National Science Council in Taiwan (NSC97-2314-B-002-043-MY3).

#### **7. References**


We are grateful to his thoughtful nomenclature for our procedure. We dare not call the

The concept of *in situ* transfer and common wall technique should be applied to redirect not only the coronary arteries but also the PAs and the aorta in TGA. Thus, tamponade, coronary events, supravalvular PS, and aortic neocoarctation can be prevented and natural spiral flow can be restored. Study of TGA and its natural or secondary natural history provides a means to understand the functional implications of the normal cardiac anatomy. As said by Einstein: "All our science, measured against reality, is primitive and child-like and yet is the most precious thing we have." How to restore TGA as much as possible to resemble its natural and unique likeness, awaits further modification and continued effort to conceive more surgical options in the coming half-century. Those stick to the surgical principle of nature and even distribution using autologous tissues, although more difficult and technically demanding, will be revived again and again, as shown by examples such as Senning versus Mustard, arterial switch versus atrial redirection, Nikaidoh versus Rastelli,

We are indebted to all our colleagues in Taiwan who contributed or help to earlier studies establishing the concepts of our ideas in congenitally malformed hearts. We are grateful to Miss Chang-Ying Lin for the preparation of Figures. This study was supported by a grant

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arterial Senning versus arterial Mustard----etc.

**6. Acknowledgement** 

**7. References** 

**5. Conclusions** 


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**10** 

*UK* 

*University of Bristol,* 

**Gene Expression Profiling - A New Approach** 

Congenital heart defects (CHD) affect approximately 1% of live births. Some of them are associated with a significant morbidity and mortality and congenital heart diseases remain the first cause of death among infants in North America and Europe (Bruneau, 2008). The major causes in CHD are thought to be chromosomal aberrations or mutations in genes regulating cardiac development during embryogenesis (Pierpont et al., 2007). However, from the epidemiological data, it seems that the environment can have a small "teratogenic" effect (Jenkins et al., 2007). For example, some substances (e.g. prenatal exposure to angiotensin converting-enzyme inhibitors, alcohol abuse and Rubella virus) can alter the function of certain genes during embryogenesis (Bruneau, 2008; Cooper et al., 2006). Though, these epidemiological studies have mostly suggested risk rather than pinpointing

During heart development complex interactions, among cells originating from different cell lineages, occur. In normal human heart development, a four-chambered heart ensure normal cardiac physiology with a right heart serving to the low-pressure pulmonary system and a left heart to the high pressure body circulation (Srivastava, 2004). A malformed cardiac growth results in abnormal hemodynamic characteristics because of volume or

The completion of the Human Genome Project heralded the beginning of a new medical science era. The available genomic data will markedly improve our ability to diagnose and treat a great number of diseases including heart disease. Examining an individual's genomic profile or "molecular fingerprint" in a disease context now might help us to understand disease mechanisms and could found a new health care tailored to individual patient that take into account the predicted disease course and response to therapies of that patient. There's now a real opportunity to replace invasive diagnostic tests with genomic tests that can be

The objective of this chapter is to provide an overview of gene expression profiling technology and the state of genomic research in congenital heart diseases, specifically with

Congenital heart defects, affecting most heart's parts (Figure 1), can be classified into three categories: cyanotic heart disease, left-sided obstruction defects and septation defects (Bruneau, 2008). In cyanotic heart disease, the mixing of oxygenated and deoxygenated

carried out with no or little risk or stress to the patients (Bell, 2004; Collins et al., 2003).

**1. Introduction** 

the underlying disease mechanisms.

regard to the use of microarray approach.

**2. Clinical overview of congenital heart diseases** 

pressure overload leading to an adaptation process of the heart.

**in the Study of Congenital Heart Disease** 

Mohamed T. Ghorbel, Gianni D. Angelini and Massimo Caputo

