International Freddie Award Winner For 2005 “The Helical Heart” Gerald D. Buckberg, M.D. Educational Objective The ongoing mystery of the heart’s muscle structure has been the inability to unravel its internal configuration, causing this internal structure to be called the “Gordian Knot of Anatomy”. This DVD shows the simplicity of cardiac form, where F. Torrent Guasp uses hand dissection to unwind the “rope like” helical structure to show a form that mimics the architecture of a cathedral. Entry Summary The Helical Heart Unfolding: A revolution in cardiac anatomy. The heart was thought to have a helical structure for 500 years. However, unwinding the structure to define this configuration has not been possible until Dr. F. Torrent-Guasp used hand dissection to successfully unfold this “Gordian Knot” of anatomic architecture, and demonstrate for the world the ventricular myocardial band. Re-scrolling this cardiac structure into its natural biologic configuration shows two loops that contain an external horizontal basal loop that wraps around the internal apical loop forming the helical heart, whereby the oblique fibers of the left and right ventricles contain a double helix with a conical apex. The commonality of this double helical form simulates the natural configuration of DNA, reciprocal patterns within flower bed petals, and the double spirals of the galaxy, to form a natural shape theme that now includes a cardiac component. The resultant architecture of the gothic apical loop helix that is surrounded by a horizontal basal loop buttress creates the configuration of a cathedral, like Notre Dame in Paris. Function within this helical shape causes the twisting (or wringing) of heart muscle to allow for ejection of blood toward the body, and then reciprocal twisting or unwringing for suction to allow rapid cardiac filling for the next heart beat. These orderly steps are defined by clinical images and by animation. The power of this structure is the simplicity of formation, as these sequential actions recur during every heart beat. Disruption of this normal shape relationship occurs when the conical (or elliptical) heart that looks like a football becomes a sphere and develops a basketball shape. Such distortion of the normal geometric form causes the enlarged heart of patients with congestive heart failure, the leading cause of death in the world. Actions are described to show how surgical rebuilding of the spherical basketball form to restore the normal football shape is effectively used to treat our leading cause of death. This helical configuration will soon appear in the leading texts of anatomy in books written by Clemente and by Moore and Dalley. When this concept was introduced at a recent Anatomy meeting Dalley said “Modern technology changes many things, but not anatomy. Now the myocardial band has changed anatomy”. The novel insight brought by unraveling the helical heart structure, and uncovering the resultant function may allow the myocardial band to create a revolution in thinking about cardiovascular dynamics that could rival the work of William Harvey in 1638.

click photos to enlarge