Development of the interatrial wall during the ontogenesis of foetuses and children up to one year of age
Abstract
Background: The foramen ovale, present in foetal interatrial septum, plays an important role during foetal life. During delivery, foramen ovale closes and becomes fossa ovalis, starting the pulmonary circulation. The aim of our study was to describe the growth of the interatrial wall and changes in location of the foramen ovale, and fossa ovalis during the ontogenesis in the human hearts.
Materials and methods: The study was performed on post-mortem material obtained from 92 human hearts from 22nd week of foetal life up to 1 year of age, fixed in a 4% formalin solution.
Results: The interatrial wall size in the studied development period was greater in the horizontal than in the vertical dimension. During ontogenesis up to 1 year old, the anterior and inferior parts of the interatrial wall increased their shares considerably by 8% and 6%, respectively. The percentage participation of foramen ovale in the interatrial wall construction in the foetal period formed more than 50% of its size and fairly decreased reaching in infants about 39%.
Conclusions: Our study demonstrated that during ontogenesis, from the foetal period to infancy, the parts of the interatrial wall increase their dimensions unevenly. The foramen ovale growth is smaller, compared to the rest of the interatrial wall development. On the basis of our data we can assume that the foramen ovale centre tends to be found in the postero-inferior quadrant of the interatrial wall (foetuses) and in postero-superior quadrant of the interatrial wall — in infants.
Keywords: interatrial wallforamen ovalefossa ovalisright atrium
References
- Jensen B, Spicer DE, Sheppard MN, et al. Development of the atrial septum in relation to postnatal anatomy and interatrial communications. Heart. 2017; 103(6): 456–462.
- Joshi SD, Chawre HK, Joshi SS. Morphological study of fossa ovalis and its clinical relevance. Indian Heart J. 2016; 68(2): 147–152.
- Kalish BT, Tworetzky W, Benson CB, et al. Technical challenges of atrial septal stent placement in fetuses with hypoplastic left heart syndrome and intact atrial septum. Catheter Cardiovasc Interv. 2014; 84(1): 77–85.
- Kucybała I, Ciuk K, Klimek-Piotrowska W. Clinical anatomy of human heart atria and interatrial septum - anatomical basis for interventional cardiologists and electrocardiologists. Part 1: right atrium and interatrial septum. Kardiol Pol. 2018; 76(3): 499–509.
- Mackesy MM, Kalish BT, Tworetzky W, et al. Sonographic pulmonary abnormalities in fetuses with hypoplastic left heart syndrome and intact atrial septum undergoing attempted atrial septostomy in utero. Ultrasound Q. 2017; 33(1): 82–85.
- Moore KL, Persaud TV. The cardiovascular system. In: The Developing Human, Clinically Oriented Embryology 7 th ed. Saunders, Elsevier, Philadelphia, Pennsylvania 2003: 340–345.
- Padilla T, Zapata M, Díaz LH, et al. Results of balloon atrial septostomy as preparation for surgical correction in transposition of great arteries. World J Pediatr Congenit Heart Surg. 2011; 2(2): 249–252.
- Paulsen F, Waschke J. Thorax. In: Sobotta, Atlas der Anatomie des Menschen. Innere Organe 23th ed. Urban &Fischer 2010: 6–7.
- Rashkind W. Creation of an atrial septal defect without thoracotomy. A palliative approach to complete transposition of great arteries. JAMA. 1966; 196(11): 991–992.
- Rashkind WJ. Transcatheter treatment of congenital heart disease. Circulation. 1983; 67(4): 711–716.
- Reig J, Mirapeix R, Jornet A, et al. Morphologic characteristics of the fossa ovalis as an anatomic basis for transseptal catheterization. Surg Radiol Anat. 1998; 19(5): 279–282.
- Sadler TW. Cardiovascular system. In: Langman’s Medical Embryology 12th ed. Lippincott Williams & Wilkins, Philadelphia 2013: 171–177.
- Vigneswaran TV, Zidere V, Miller OI, et al. Usefulness of the prenatal echocardiogram in fetuses with isolated transposition of the great arteries to predict the need for balloon atrial septostomy. Am J Cardiol. 2017; 119(9): 1463–1467.
