Morphological Study of Fossa Ovalis in Formalin-Fixed Human Hearts and Its Clinical Importance.

Monica Adriana Vaida,Adelina Maria Jianu,Laura Grigoriță,Cristina Gug,Andreea Grigoriță,Nawwaf Sebastian Damen,Caius Glad Streian

doi:10.3390/medicina57111254

Monica Adriana Vaida, Adelina Maria Jianu + Show 5 more

Open Access

https://doi.org/10.3390/medicina57111254

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Abstract

Background and Objectives: Our study aimed to investigate the gross anatomy aspects of the fossa ovalis (FO) and the presence of some anatomical variation resulting from the incomplete fusion of septum primum and septum secundum, such as an atrial septal pouch (SP) and left atrial septal ridge. Materials and Methods: Thirty-one adult human hearts removed from formalin-fixed specimens were examined to provide information about the morphology of the FO. The organs were free of any gross anatomically visible pathological conditions. Results: The most common variants were the FO located in the inferior part of the interatrial septum (64.51%), circular (61.3%), with a net-like structure (51.62%), prominent limbus (93.55%), and patent foramen ovale (PFO) (25.8%). The right SP was observed in 9.67% of specimens, the left SP was observed in 29.03% of cases, and in 51.61% of cases, a double SP was observed. One sample presented a right SP and a double left SP, and one case showed a triple left SP, which was not reported previously to our knowledge. Conclusions: Knowledge of the interatrial septal anatomy becomes important for interventional cardiologists and should be documented before transeptal puncture.

Highlights

A true septum represents a partitioning wall shared by two structures [1], which can be removed without exiting the heart’s cavities [2]
Septation of the atrium begins with the formation of the septum primum, crescentic sagittal septum, which grows from the roof of the common atrium toward the atrioventricular septum, formed by the endocardial cushions developed in the atrioventricular canals [5]
The opening left in the septum secundum is called the foramen ovale

Summary

Introduction

A true septum represents a partitioning wall shared by two structures [1], which can be removed without exiting the heart’s cavities [2]. The opening left in the septum secundum is called the foramen ovale It allows blood circulation from the right atrium to the left atrium during fetal life. In monotreme and marsupial mammals, birds, and reptiles, the perforations in the septum primum do not coalesce to form the ostium secundum They are sealed by myocardial and endocardial growth after birth [7]. According to Anderson [2], the septum primum persists as the valve of the foramen ovale, the classical septum secundum represents an infolding from the atrial roof, which forms the superior part of the limbus of the fossa ovalis (FO), and the rest of the limbus is produced by the muscularization of the vestibular spine. Conclusions: Knowledge of the interatrial septal anatomy becomes important for interventional cardiologists and should be documented before transeptal puncture

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