Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T09:17:29.886Z Has data issue: false hasContentIssue false

Mobility of the flap valve of the primary atrial septum in the developing human fetus

Published online by Cambridge University Press:  19 August 2008

Cora Firpo*
Affiliation:
Fetal Cardiology Unit, Institue of Cardiology of Rio Grande Do Sul, Brazil
Paulo Zielinsky
Affiliation:
Fetal Cardiology Unit, Institue of Cardiology of Rio Grande Do Sul, Brazil
*
Dr Cora Firpo Unidade De Pesquisa-IC/FUC, Av. Princesa Isabel, 395, Porto Alegre, RS, Brazil. Tel: 051-223.6377-Ext 149; Fax: 55-51-2236408

Abstract

It has already been suggested that redundancy of the primary atrial septum could be associated with primary fetal arrhythmias. There are few reports, however, concerning the mobility of the primary septum and its behavior during fetal life. In this study, fifteen fetuses without anatomic heart disease were serially evaluated by fetal echocardiography. The time interval between three separate examinations was at least two weeks. A redundancy index was calculated as the ratio between the maximum excursion of the flap valve of the septum and the maximal left atrium as seen in a four chamber view. The indexes observed in the three examinations were: 0.55 ± 0.15, 0.48 ± 0.13 and 0.41 ± 0.13, respectively. Analysis of variance for normal distribution and Tukey's test were performed. A significant decrease (p < 0.05) in the redundancy index was observed with increasing gestational age. We postulate that this finding may be related to the decrease in frequency of premature atrial beats throughout fetal life.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Friedman, AH, Copel, JA, Kleinman, CS. Fetal echocardio graphy and fetal cardiology: indications, diagnosis and management. Semin Perinatol 1993; 17:7688.Google Scholar
2. Kiserud, T, Eik-Nes, SH, Blass, HG, Hellevik, LR. Foramen ovale: an ultrasonographic study of its relation to the inferior vena cava, ductus venosus and hepatic veins. Ultrasound Obstet Gynecol 1992; 2:389396.CrossRefGoogle Scholar
3. Walther, FJ, Benders, MJ, Leighton, JO. Early changes in the neonatal circulatory transition. J Pediatr 1993; 123:625632.CrossRefGoogle ScholarPubMed
4. Rudolph, AM. The changes in the circulation after birth. Their importance in congenital heart disease. Circulation 1970; 41:343359.CrossRefGoogle ScholarPubMed
5. Sahn, DJ, Allen, HD, Anderson, R, Goldberg, SJ. Echocardiography diagnosis of atrial septal aneurysm in an infant with hypoplastic right heart syndrome. Chest 1978;73:227230.CrossRefGoogle Scholar
6. Roberts, WC. Aneurysm (redundancy) of the atrial septum (fossa ovale membrane) and prolapse (redundancy) of the mitral valve. Am J Cardiol 1984; 54:11531154.CrossRefGoogle ScholarPubMed
7. Iliceto, S, Papa, A, Sorino, M, Rizzon, P. Combined atrial septal aneurysm and mitral valve prolapse: detection by twodimensional echocardiography. Am J Cardiol 1984;54:11511153.CrossRefGoogle ScholarPubMed
8. Alexander, MD, Bloom, KR, Hart, P, D'Silva, F, Murgo, JP. Atrial septal aneurysm: a cause for midsystolic click. Circulation 1981; 63:11861188.CrossRefGoogle ScholarPubMed
9. Gallet, B, Malergue, MC, Adams, C, Saudemont, JP, Collot, AMC, Druon, MC, Hiltgen, M. Atrial septal aneurysm - a potential cause of systemic embolism. Br Heart J 1985;53:292297.CrossRefGoogle ScholarPubMed
10. Pearson, AC, Nagelhout, D, Castello, R, Gomez, CR, Labovitz, AJ. Atrial septal aneurysm and stroke: a transesophageal echocardiography study. J Am Coil Cadiol 1991; 18:12231229CrossRefGoogle Scholar
11. Casts, A, Casta, D, Sapire, DW, Swischuk, L. True Congenital aneurysm of the septum primum not associated with obstructive right — or left-sided lesions: identified by two-dimensional echocardiography and angiography in a newborn, Ped Cardiol 1983; 4:159162.CrossRefGoogle Scholar
12. Rice, MJ, McDonald, RW, Reller, MD. Fetal atrial septal aneurysm: a cause of fetal atrial arrhythmias. J Am Coil Cardiol 1988; 12:12921297.CrossRefGoogle ScholarPubMed
13. Stewart, PA, Wladimiroff, JW. Fetal atrial arrhythmias associated with redundancy/aneurysm of the foramen ovale. J Clin Ultrasound 1988; 16:643650.CrossRefGoogle ScholarPubMed
14. Toro, L, Weintraub, RG, Shiota, T, Sahn, DJ, Sahn, C, McDonald, RW, Rice, MJ, Hagen-Ansert, S. Relation between persistent atrial arrhythmias and redundant septum primum flap (atrial septal aneurysm) in fetuses. Am J Cardio 1994;73:711713.CrossRefGoogle ScholarPubMed
15. Zielinsky, P, Firpo, CM, Lima, RP, Martha, VF, Silva, ES. Estudo ecocardiográfico pré-natal da redundância do septum primum e sua relaçao com a génese de extra-sístoles atriais no feto. Arq Bras Cardiol. 1995. 65:153157.Google Scholar
16. Zielinsky, P, Firpo, CM, Lima, RP, Martha, VF, Silva, ES. Papel da membrana da fossa oval no desencadeamento de arritmias cardíacas fetais. Rev Bras Ginec Obstet 1995; 17:711–7 19.Google Scholar
17. Sahn, DJ. Perspectives in fetal echocardiography. Cardiol Young 1994; 4:90–8.CrossRefGoogle Scholar
18. Maragnés, P, Fournier, A, Lessard, M, Fouron, JC. Evaluation et pronostic des arythmies foetales. Pediatric 1991;46:481488.Google Scholar
19. Tulzer, G, Huhta, JC, Gudmundsson, S, Tews, G, Arzt, W, Schmitt, K. Fetale supraventrikulsre extrasystolie: eine indikation zur fetalen echokardiographie? Klin Pädiatr. 1994; 206:430432.CrossRefGoogle Scholar
20. Kleinman, CS, Donnerstein, RL, Jaffe, CC, DeVore, GR, Weinstein, EM, Lynch, DC, Tamer, NS, Berkowitz, RL, Hobbins, JC. Fetal echocardiography. A tool for evaluation of in utero cardiac arrhythmias and monitoring of in utero therapy: analysis of 71 patients. Am J Cardiol 1983; 51:237243.CrossRefGoogle Scholar
21. Fyfe, DA, Meyer, KB, Case, CL. Sonographic assessment of fetal cardiac arrhythmias. Semin ultrasound CT MRI 1993; 14:286297.CrossRefGoogle ScholarPubMed