University of California at Irvine Medical Center, Orange, California 92868, USA.
JACC Cardiovasc Interv. 2010 Jan;3(1):98-104. doi: 10.1016/j.jcin.2009.07.017.
The purpose of this study was to develop a better understanding of the pathophysiology of the condition, we studied the patterns by which the septum primum (SP) and septum secundum (SS) fuse.
A patent foramen ovale (PFO) is a communication across the interatrial septum between a nonadherent SP and SS and is considered to be a risk factor for serious clinical syndromes.
We examined the interatrial septum in 94 randomly selected autopsied hearts, with a focus on the SP and SS and the patterns by which the 2 structures fuse.
Of the 94 specimens that were suitable for analysis, 26 (27.66%) had a PFO. Of the remaining 68 hearts, complete fusion of the SP and SS along the entire zone of overlap was seen in 27 (28.7%) hearts. In the remaining 41 hearts (60.29%), a PFO was absent, but incomplete fusion of the SP and SS was seen. Of 41 hearts, 37 (90%) had a septal pouch that opened into the left atrial (LA) cavity. Four hearts (10%) had a pouch accessible from the right atrium. Hearts with left-sided pouches tended to be younger (50 +/- 18 years of age) than hearts where there was complete fusion (age 63 +/- 23 years) (p = 0.06).
Our data suggest that when a foramen ovale closes spontaneously, the SP and SS fuse initially at the caudal limit of the zone of overlap of the 2 structures. This incomplete fusion results in a pouch that, in the majority of instances, communicates with the LA cavity.
本研究旨在深入了解该病症的病理生理学机制，因此我们研究了原发隔（SP）和继发隔（SS）融合的模式。
卵圆孔未闭（PFO）是指房间隔中 SP 和 SS 之间的非粘连性连通，被认为是严重临床综合征的危险因素。
我们检查了 94 例随机选择的尸检心脏的房间隔，重点研究 SP 和 SS 以及这两个结构融合的模式。
在 94 个适合分析的标本中，有 26 个（27.66%）存在 PFO。在其余 68 个心脏中，有 27 个（28.7%）心脏的 SP 和 SS 沿整个重叠区完全融合。在其余 41 个心脏（60.29%）中，不存在 PFO，但 SP 和 SS 不完全融合。在 41 个心脏中，有 37 个（90%）存在一个向左心房（LA）腔开放的隔袋。有 4 个心脏（10%）的隔袋可从右心房进入。有左隔袋的心脏往往比完全融合的心脏年轻（50 +/- 18 岁）（年龄 63 +/- 23 岁）（p = 0.06）。
我们的数据表明，当卵圆孔自发关闭时，SP 和 SS 最初在这两个结构重叠区的尾端融合。这种不完全融合导致隔袋在大多数情况下与 LA 腔相通。
