Abstract
We studied the ratio of the foramen ovale area to the total atrial septum area in 18 normal hearts and 33 hearts with congenital cardiac anomalies. The congenital defects included tricuspid atresia, 5; pulmonary atresia, 4; secundum atrial septal defect, 9; coarctation of the aorta, 8; and aortic stenosis, 7. In the 10% formalin fixed specimens, the margins of the atrial septum were defined and marked with India ink. The hearts were coded, positioned with the septum flat and photographed with a grid. The areas of the atrial septum and foramen ovale were measured using standard planimetric techniques. A ratio of the foramen ovale to atrial septal area was calculated. The area of the atrial septum did not differ significantly among the six groups. The foramen ovale/atrial septal ratio in normal hearts was 0.19 ± .01 (SEM). The ratios in tricuspid atresia (0.41 ± .02), pulmonary atresia (0.38 ± .02), and secundum atrial septal defect (.37 ± .01) were significantly larger than normal (p<.05) while the ratio in coarctation of the aorta (0.15 ± .01) and aortic stenosis (0.11 ± .01) were significantly smaller (p<.05). These data indicate that foramen ovale size is directly related to the magnitude of trans-atrial blood flow during embryonic and fetal development, and provide support for the role of intracardiac blood flow in cardiac morphogenesis.
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