DEVELOPMENT OF THE
CVS
Development of the CVS
• Development of heart
• Applied
• Vasculogenesis
• Applied
Atrial Septal defects (ASD)
• There are 4 types of clinically significant
types of ASD :
• Ostium secundum defect (with patent oval foramen).
• Endocardial cushion defect (with ostium primum
defect).
• Sinus venosus defect.
• Common atrium…. Rare cardiac defect, in which the
interatrial septum is absent due to failure of septum primum &
septum secundum to develop.
Atrial septal defect (ASD):(ostium secundum defect)
A probe patent oval foramen :
Various Types of Atrial Septal Defect (ASD) in the right
aspect of interatrial septum :
Patent oval foramen :
Various Types of Atrial Septal Defect (ASD) in the right
aspect of interatrial septum :
Tetralogy of Fallot
It contains 4 cardiac defects :
1- Pulmonary stenosis
(obstruction of right ventricular
outflow).
2- Ventricular Septal Defect
(VSD).
3- Dextroposition of aorta
(overriding aorta).
4- Right ventricular hypertrophy.
Ventricular Septal Defects (VSDs):
Membranous VSD …. Is the most common type.
Results from incomplete
closure of IV foramen due to
failure of development of
memb. part of IV septum.
Large VSDs with excessive
pulmonary blood flow &
pulm. hypertension result in
dyspnea (difficult breathing)
+ heart failure.
VASCULOGENESIS
-Development of Arteries
-Development of veins
The Aortic Arches Derivatives
During the 4th week, as the pharyngeal arches
develop, they are supplied by the aortic arches.
Aortic arches arise from the aortic sac and terminate in
the dorsal aorta.
There are 6 pairs of aortic arches, but they are never
present at the same time.
During 8th w. the primitive aortic arch pattern is
transformed into final fetal arteries.
Branches of the dorsal aorta :
1- Cervical dorsal intersegmental arteries join to form vertebral
artery on each side (7th cervical intersegmental artery forms the
subclavian artery).
2- Thoracic dorsal intersegmental arteries persist as intercostal
arteries.
3- In the lumbar region, they persist forming lumbar arteries, but
5th lumbar enlarge and forms common iliac artery.
4- In the sacral region, they form lateral sacral arteries , but the
caudal end of dorsal aorta becomes the median sacral artery.
Derivatives of 1st & 2nd pairs of aortic
arches :
The 1st aortic arches largely disappear. small
parts persist to form the maxillary arteries.
The 2nd aortic arches disappear leaving small
parts forming the stapedial arteries (run through
the ring of the stapes, a small bone in middle
ear).
Aortic Arches Arteries
Derivatives of 3rd & 4th pairs of aortic arches
The 3rd arch artery persists forming the common carotid
artery and proximal part of internal carotid artery (on both
sides), it joins with the dorsal aorta to form the distal part of
int.c.artery. The ext.c.artery develops as a new branch
from 3rd arch.
The 4th arch forms the main part of the arch of aorta… on
left side, and forms the proximal part of right
subclavian artery … on the right side.
The distal part of Rt.subclavian artery develops from the
right dorsal aorta & right 7th intersegmental artery.
The left subclavian artery …. is not derived from aortic
arch but from the left 7th intersegmental artery.
Proximal part of the arch of aorta develops from the aortic
sac , and the distal part from left dorsal aorta.
Derivatives of 5th & 6th pairs of aortic arches
The 5th arch artery disappears in 50% and in the other 50% of
the embryos, these arteries do not develop.
The 6th arch artery:
a- proximal part on both sides … forms the pulmonary artery.
b- distal part of left artery : forms ductus arteriosus which
connects left pulmonary artery with arch of aorta.
C- distal part of right artery : disappears.
The dorsal aorta on the right side caudal to 4th arch disappears
down to the single dorsal aorta, while persists on left side to form
descending aorta.
Development of the arch of aorta
1- its proximal part develops from left part of distal
part of aortic sac (right part of aortic sac forms brachio -
cephalic artery).
Proximal part of aortic sac forms the pulmonary trunk.
2- its main middle part develops from left 4 th aortic arch.
3- its distal part develops from the left dorsal aorta
between 4th & 6th aortic arches.
Aortic Arches Arteries
The relation of recurrent laryngeal
nerves to the aortic arches
Final development of the arteries from the aortic
arches arteries :
Coarctation of the aorta :
Development of veins associated
with the heart of 4th week embryo
Vitelline veins return
poorly oxygenated blood
from yolk sac to the sinus
venosus of heart.
Umbilical veins carry
well-oxygenated blood
from primordial placenta
to sinus venosus.
Common cardinal veins
carry poorly oxygenated
blood from body of
embryo to sinus venosus
Vitelline Veins
• Pass through the septum
transversum and drain into
the sinus venosus
• In relation to the liver
developing within the
septum transversum, the
vitelline veins are divided
into:
Pre-hapatic part: forms
anastomosis around the
duodenum which later on
gives rise to the portal
vein
Hepatic part: interrupted
by the liver cords, forms
an extensive vascular
network called the
hepatic sinusoides
Post-hepatic part:
Left vein disappears
Right vein forms the:
Hepatic veins &
Hepatic segment
of inferior vena
cava
Umbilical Veins
• Bring oxygenated blood
from the placenta
• Initially run on each side
of the developing liver
and drain into the sinus
venosus
• As the liver grows, the
umbilical veins loose
their connection with
heart and open into the
liver
• The right vein
disappears by the end
of the embryonic period.
The left vein persists
Anterior Cardinal Veins
Posterior Cardinal Veins
The only adult
derivatives of
posterior cardinal
veins are : root of
azygos vein + common
iliac veins.
Sub cardinal & Supracardinal Veins
Drawings illustrating ventral views of
primordial veins of trunk : vitelline ,umbilical &
cardinal veins, and also subcardinal &
supracardinal veins.
Fate of Sub-cardinal veins
Left subcardinal vein cranial to the anastomosis
disappears leaving small left suprarenal vein, while
caudal to anastomosis it becomes left gonadal vein.
Right subcardinal vein cranial to the anastomosis
forms the pre-renal part of I.V.C. + right suprarenal vein,
while caudal to the anastomosis it develops into right
gonadal vein.
Sub-supracardinal anastomosis forms right & left
renal veins + renal part of I.V.C.
Ventral views of primordial veins of trunk’s embryo.
C, 8th week.
D, adult.
Fate of Supracardinal veins
They are the last pair of vessels to develop.
The middle part of the 2 veins in the region of kidney
disappears.
Cranial part of left supracardinal vein + transverse
anastomosis form Hemiazygos vein.
Cranial parts of right supracardinal vein + right
posterior cardinal vein form Azygos vein.
Caudal to the level of kidney : right supracardinal vein
Ventral views of primordial veins of trunk’s embryo.
forms postrenal part of I.V.C., while left
C, 8th week.
supracardinal vein disappears.
D, adult.
Development of I.V.C
Hepatic part : develops from hepatic vein
(from proximal part of right vitelline vein) + hepatic
sinusoids.
Prerenal part : develops from right subcardinal vein.
Renal part : develops from subcardinal-supracardinal
anastomosis.
Postrenal part : develops from right supracardinal
vein.
.
Anomalies of the Venous System
• Persistent left SVC (double SVC): is the
most common defect
• Left SVC
• Absence of IVC
• Double IVC
Double
Arch of
Aorta With
Double
Superior
Vena Cava
Fetal Circulation
The main features of the
fetal circulation are:
• Nonfunctioning lungs
• Course of the blood from
the placenta to the heart
• Three shunts permitting
the blood to bypass the
liver and lungs:
Foramen ovale
Ductus venosus
Ductus arteriosus
• The oxygenated blood
from the placenta
reaches the fetus by
umbilical vein
• Most of the blood
bypasses the liver
through the ductus
venosus, although little
blood enters the liver
• In the inferior vena
cava, the oxygenated
blood mixes with the
deoxygenated blood
arriving from the fetus
• IVC opens into the right
atrium. In the right
atrium, the caval blood is
guided into the left atrium
through the foramen
ovale.
• However, little blood
remains in the right
atrium, which mixes with
the blood arriving through
the superior vena cava.
• In the left atrium also, the
oxygenated blood mixes
with deoxygenated blood
arriving from the lungs.
• Blood enters the left ventricle
and then into the ascending
aorta. Thus the heart and the
brain receive better oxygenated
blood.
• The blood from the right atrium
enters into the right ventricle,
and from there into the
pulmonary artery.
• Most of the blood from the
pulmonary artery enters into
the aorta through the ductus
arteriosus.
• From the aorta, the blood is
distributed to body tissues and
flows through the umbilical
arteries into the placenta.
• The blood circulating in
the fetal arterial system V
is not fully oxygenated
• There is mixing of IV
oxygenated and III
deoxygenated blood in II
the:
I. Liver sinusoids
I
II. Inferior vena cava
III.Right atrium
IV.Left atrium
V.Descending aorta.
What happens at birth?
Oh… let me take a
deep breath… and
then everything
will be OK
• At birth, dramatic changes occur in the
circulatory pattern.
• The changes are initiated by baby’s first
breath.
Fetal lungs begin to function
Placental circulation ceases
The three shunts that short-circuited the
blood during the fetal life cease to
function
Neonatal Circulation
1. The infant’s lungs begin to function:
The lungs inflate, which tends to draw blood from the
right ventricle.
Oxygenated blood from the lungs passes through
pulmonary veins to left atrium. The increased
pressure in the left atrium results in closure of the
foramen ovale. effectively separating the two atria.
This also increases blood flow to the lungs as
blood entering the right atrium can no longer bypass
the right ventricle, which pumps it into the pulmonary
artery and on to the lungs.
2. The placental circulation ceases.
Umbilical vessels are no longer needed. They
become obliterated
Occlusion of the placental circulation causes fall of
blood pressure in the inferior vena cava and right
atrium
3. The shunts stop to function:
Within a day or two of birth, the ductus arteriosus
closes off, preventing blood from the aorta from
entering the pulmonary artery
The ductus venosus closes off so that all blood
entering the liver passes through the hepatic
sinusoids.
Adult Derivatives of Fetal Vascular
Structures
• Ductus venosus becomes the ligamentum venosum,
attached to the inferior vena cava.
• Ductus arteriousus becomes ligamentum
arteriousum
• Foramen ovale closes shortly after birth, fuses
completely in first year and becomes fossa ovalis
• The intra-abdominal portions of the umbilical arteries
become the medial umbilical ligaments
• The intra-abdominal portion of the umbilical vein becomes
the ligamentum teres.
