Despite recent advances in pediatric diagnosis and surgical intervention, mortality and morbidity continue to be a prevalent issue in both Tetralogy of Fallot (ToF) and Hypoplastic Left Heart Syndrome (HLHS). Therefore, novel approaches to studying both of these conditions is warranted. Investigating cardiac anatomical features of different species in the animal kingdom similar to the defects and complications present in ToF and HLHS (as well as others) could serve as a new avenue for improving the management of congenital heart diseases (CHD). This review reveals that although structures found in HLHS and ToF are pathological, similar structures are found in diving mammals and reptiles that are adaptive. Pathologic aortic dilation in CHD resembles the aortic bulb present in diving mammals, but the latter is more elastic and distensible compared to the former. The unrepaired HLHS heart resembles the univentricular heart of non-crocodilian reptiles. Right ventricle hypertrophy is pathological in HLHS and ToF, but adaptive in crocodilians and diving mammals. Lastly, the increased pulmonary resistance due to pulmonary stenosis in ToF is comparable to increased pulmonary resistance in crocodilians due to the presence of an active valve proximal to the pulmonary valve. Some of these anatomical structures could potentially be adapted for palliative surgery in children with HLHS or ToF. Moreover, further investigating the underlying molecular signals responsible for the adaptive tissue responses seen in other species may also be useful for developing novel strategies for preventing some of the complications that occur after surgical repair in both of these CHDs.

中文翻译：

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海洋动物的心脏结构为儿童先天性心脏缺陷的潜在干预提供了见解

尽管最近儿科诊断和手术干预取得了进展，但死亡率和发病率仍然是法洛四联症 (ToF) 和发育不良左心综合征 (HLHS) 的普遍问题。因此，研究这两种情况的新方法是有必要的。研究动物界不同物种的心脏解剖特征，类似于 ToF 和 HLHS（以及其他）中存在的缺陷和并发症，可以作为改善先天性心脏病 (CHD) 管理的新途径。这篇综述表明，虽然在 HLHS 和 ToF 中发现的结构是病理性的，但在适应性强的潜水哺乳动物和爬行动物中也发现了类似的结构。CHD 的病理性主动脉扩张类似于潜水哺乳动物中的主动脉球，但与前者相比，后者更具弹性和可扩张性。未修复的 HLHS 心脏类似于非鳄鱼爬行动物的单心室心脏。右心室肥大在 HLHS 和 ToF 中是病理性的，但在鳄鱼和潜水哺乳动物中是适应性的。最后，ToF 中由于肺动脉狭窄引起的肺阻力增加与鳄鱼由于肺动脉瓣近端存在主动瓣膜而增加的肺阻力相当。其中一些解剖结构可能适用于 HLHS 或 ToF 儿童的姑息性手术。而且，