Embryology of CVS

By Leamlak M (MD) 07/11/2004

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Out line
Introduction Development of CVS Development of the heart
Formation of primitive heart tube Bending of primitive heart tube Abnormalities of cardiac looping development of heart septae
Aorticopulmonary (AP), atrioventricular (AV), interatrial, and interventricular septum Abnormalities in septal development

Development of the arterial system

Abnormality

Development of the venous system Development of the conduction system

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Development of the cardiovascular system

Begins to function by end of the 3rd week
Necessary in order to meet nutrient needs of rapidly growing embryo.

The entire cardiovascular system heart, blood vessels, and blood cellsoriginates from the mesodermal germ layer.

 Starts as two thin walled endocardial tubes.

Development of the heart

by the 22nd day of development the two heart tube fuses and form primitive heart, develops into endocardium.
Surrounding mesenchyme thickens to form
Myocardium Epicardium

The fate of the five dilatations

Primitive heart tube bends

As primitive heart bends the atrium and sinus come to lie dorsal to the bulbus & ventricle Reversal of original cranio-caudal relationship Atrial portion being paired becomes one Atrioventricular junction remains narrow Form an atrioventricular canal Connecting atrium with the ventricle

The Interior
A portion of the ventral wall of the bulboventricular loop is removed to show the interior.

A-Ar

Since there is no partition, there is a single passage from the atrium to the ventricle. This passage is the atrioventricular canal. Note the direction of blood flow through the bulboventricular loop.

RA

LA

Also note that the single vessel leading out of the heart has given rise to what are called aortic arches.

AVC

a. abnormalities of cardiac looping

Dextrocardia= the heart lies on the right side of the thorax instead of the left, is caused because the heart loops to the left instead of the right. Dextrocardia may coincide with situs inversus, a complete reversal of asymmetry in all organs.

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. In other cases sidedness is random, such that some organs are reversed and others are not; this is heterotaxy.

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Development of heart septae

The primitive heart tube is a tube with a single lumen. This single lumen is partitioned into four definitive chambers by the formation of four septae:
Aorticopulmonary (AP), atrioventricular (AV), interatrial, and interventricular septum.

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Formation of cardiac septa

Begins around middle of 4th week & completed by end of 6th week
Two methods
Tissue growth
Two of more actively growing masses of tissue which approach each other in the same plane, fuse to divide a single chamber into two.

Overgrowth
Involves growth of a chamber at all points except for a narrow strip which fails to grow. Leaves a small canal connecting the two chambers
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. septum= divides A. Aorticopulmonary (AP)

the trunks arteriosus into aorta and pulmonary trunk
Formation= neural crest cells migrate into the truncal and bulbar ridges, which grow in a spiral fashion and fuse to form the AP septum.

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b. Defect in the formation of AP septum

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Persistent truncus arteriosus

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Tetralogy of fallot

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Transposition of great vessels

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B. Atrioventricular (AV) septum= divides the . AV canal into the right AV canal and left AV canal
Formation= the dorsal and ventral AV cushions fuse to form AV septum.

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c. Defect in the formation of AV septum

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Tricuspid atresia

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c. Atrial septum= divides the primitive . atrium into the right and left atria.
The septum primum grows toward the AV septum The foramen primum is located between the edge of septum primum and the AV septum; it is obliterated when the septum primum fuses with the AV septum The foramen secundum forms in the center of the septum primum

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 The septum secundum forms to the right . of the septum primum and fuses (after birth) with the septum primum to form the atrial septum The foramen ovale is the opening between the upper and lower parts of the septum secundum.

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d. Defect in the formation of atrial septum

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d. Interventricular septum= divides the ventricle into right and left ventricular chambers.
Formation
a. The muscular IV septum develops in the floor of the ventricle; it grows towards the AV cushions but stops short leaving the IV foramen b. The membranous IV septum forms by the fusion of three components: the right bulbar ridge, left bulbar ridge, and AV cushions. This fusion closes the IV foramen

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e. Defect in the formation of ventricular septum

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Ventricular septal defect

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Development of the arterial system

Formation
The arterial system develops from the aortic arches (contributes to arteries in the head and neck region) and dorsal aorta (contributes to the arteries of the rest of the body)

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Defect in the formation of arterial system

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Patent ductus arteriosus

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Development of the venous system

It develops from the vitelline, umblical and cardinal veins that empty into the sinus venosus. Vitelline veins=carry blood from the yolk sac to the sinus venosus Umblical veins= originate in the chorionic villi and carry oxygenated blood to the embryo Cardinal veins= drain the body of the embryo proper

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Formation of conducting system of the heart

Initially the pacemaker for the heart lies in the caudal part of the left cardiac tube. Later the sinus venosus assumes this function, and as the sinus is incorporated into the right atrium, pacemaker tissue lies near the opening of the superior vena cava. Thus, the sinuatrial node is formed. The atrioventricular node and bundle (bundle of His) are derived from two sources: (a) cells in the left wall of the sinus venosus, and (b) cells from the atrioventricular canal. Once the sinus venosus is incorporated into the right atrium, these cells lie in their final position at the base of the interatrial septum.

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Reference
Langmans Medical Embryology. 10th ed. High yield embryology. 2nd ed. Histology and embryology PPt by Dept. of Anat., Hist. & Embry School of Medicine Xian Jiaotong University. Development of the heart PPt by Avinash Bharadwaj
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 Thank U!

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