Cardiovascular Embryology Dr Akashdeep Bhatia

Developmement of Heart

Embryonic structure Gives rise to

Truncus arteriosus Bulbus cordis Primitive ventricle Primitive atria Left horn of sinus venosus Right horn of sinus venosus

Ascending aorta and pulmonary trunk Smooth parts of left and right ventriclesTrabeculated left and right ventricles Trabeculated left and right atria Coronary sinus Smooth part of right atrium

Interatrial septum development

Interartrialseptal related congenital anomaliesAtrial septal defect Two types 1)primum type: persistent of foramen primumLt to Rt shunt Overload in pulmonary circulation (pul HTN)lead

to Rt to Lt shunt Eisenmenger’s syndrome Acynotic to cynotic Mostly failure of endocardial cushion to go up ---

inadequacy of neural crest cells .Associated with valvular defects

2)Secondary type :Formation of foramen secundum

Lt to Rt shunt

Interventricular septal related congenital anomalies Tetralogy of fallot : skewed AP septun 4 components :Pulmonary stenosis overriding aorta VSD Right ventricular hypertrophyRt to Lt shunt

Transposition of great vessels: Failure to spiral

Rt to Lt shuntWith patent Ductus arteriosus good prognosis Tx: Prostaglandin agonist Surgery

Patent Truncus arteriosus (Partial AP septum development )

Mixing of DO2 and O2 blood .Always present with VSD