FMS II WEEK 2 LECTURE 4

SYNOPSIS

EMBRYOLOGY OF THE HEART

Bernard SM Hutabarat

The heart ( Cor ), that originated from mesoderm splanchnicus is the core of the Cardiovascular
system, the 1st system that function in the body of the embryo and develop in the 3rd week.
Day 18, mesoderm splanchnicus surrounding prochordal plate develop a cluster of blood cells
namely blood islands ( angiocyst ) that will coalescence at day 19 to become a pair of endocardial heart
tubes.
Cephalocaudal and lateral folding cause the pair of endocardial heart tubes develop into a
single tube namely primary ( primitive ) heart tube. Primitive heart tube differenciate into :
1. Sinus venosus, that develop into :
1.1. V. umbilicalis ( chorion )
1.2. V. Vitellina ( yolk sac ), later on develop into portal system.
1.3. V. Cardinalis communis ( embryo), later on develop into Caval vein system.
2. Primordial ( primitive ) atrium
3. Ventricle
4. Bulbus cordis.
Endocardial heart tube later on develop into 5 dilations,namely truncus arteriosus, bulbus
cordis, ventricle, atrium and sinus venosus . Bulbus cordis and ventricle make bulboventricular part
( pars bulboventricularis ) of the developing heart.
Day 23 – 28 elongation of pars bulboventricularis develop into cor triloculare ( atrium communis
and ventricles ).
At day 28 from the roof of atrium communis a protrusion called septum primum develop towards
the endocardial cushion,but before reaching endocardial cushion there was absorbtion of septum
primum, thence septum primum failed to reach endocardial cushion. The opening between septum
primum and endocardial cushion was called foramen primum.
In the mean time , before absorbtion of septum primum completed, another protrusion develop
from the roof of atrium communis towards endocardial cushion, namely septum secundum . Before
reaching endocardial cushion, septum secundum also being absorbed causing an oval foramen
develop between septum primum and septum secundum, thence called foramen ovale.
During week 5, four swellings develop at the outflow tract and the unison of the swelling
commence peripheral truncal swelling and central conus swelling. Together those 2 swellings form
septum aorticopulmonale ( Aorticopulmonal septum ).
With sulcus bulboventricularis as fixed point, septum aorticopulmonalis rotate as follows :
1. Rotation of peripheral bulbar orifice :
1.1. First rotation 180º Counter Clock Wise Rotation ( CCWR )
1.2. Second rotation 150º Clock Wise Rotation ( CWR )
2. Rotation of central bulbar orifice : .
2.1. First rotation 90º CWR
2.2. Second rotation 45º CCWR
The result of the rotation is the spiral form of septum aortico pulmonalis so that Aorta originated
from Left ventricle and A. Pulmonalis from right ventricle.
Components of fetal circulation:
1. Placenta
2. A/V umbilicales
3. Ductus venosus Arantii ( Hepar by pass )
4. V. cava inferior & valvula venae cavae inferiores Eustachii

1
 5. Foramen ovale
6. Crista dividens Amoroso
7. Ductus arteriosus Botalli
Changes after birth consists of :
1. V. umbilicalis became lig. Teres hepatis
2. Aa umbilicales became Ligg vesicoumbilicales lateralis dextra et sinistra
3. Ductus venosus Arantii became lig. Venosum Arantii
4. Foramen ovale became Fossa ovalis.
5. Ductus arteriosus Botalli became chorda ligamentosum arteriosum Botalli ( lig. Arteriosum
Botalli. )
Malformatio congenitalis consists of abnormalities of :
1. Cardiac septum.
1.1. Patent foramen ovale
1.2. VSD
2. Truncus and conus : Tetralogy Fallot
3. Ductus arteriosus Botalli
4. Rotation : TGV