Cardiovascular Embryology

Contents:
 1. Heart development
 the horseshoe-shaped pericardial cavity
 formation of the single heart tube
 the convolution of the heart tube
 the primitive 4-chambered heart
 atrial septation
 ventricular septation
 aorticopulmonary septation

 2. Development of arteries
 3. Development of veins
 4. Fetal circulation
 Development of Cardiovascular System
Somite
Connecting stock
Amniotic cavity

Somatic mesoderm
Ectoderm

Intraembryonic
mesoderm Splanchnic mesoderm

Endoderm

Notochord
Trophoblast
Yok sack

Extraembryonic Chorionic layer

mesoderm
Day 18 Development of heart
Horseshoe-Shaped Pericardial Cavity
In splanchnic mesoderm
Primary Blood
heart islands
field
Blood islands formed
of hemangioblasts

Endocardial
heart tube
Prospective
myoblasts

Prospective
angioblasts
 Horseshoe-Shaped Pericardial Cavity
Days 19- 20:

The splanchnic mesoderm with two endocardial

tubes moves medially in front of developing
foregut.
 Single Heart Tube

Day 21: Heart tube

Coronal • Dorsal mesocardium Sagittal section

section
• Myoepicardial mantle
• Cardiac jelly
• Single heart tube
Heart Tube
Fusion
Day 21:
Embryonic Circulation
Day 21:
Endocardial Heart Tube
Aortic arches I
II

III Hand 1

Aortic sac
Bulbus
cordis Truncus arteriosus Hand 2

Conus cordis

Primitive ventricle

Atrium Tbx5

Right sinal horn

RA
CV
UV Left sinal horn
Day 23:
Convolution of the Heart Tube

Truncus

Aortic Sac LA
RA
Ventricle
Truncus

Conus

Conus Atria

Primitive
Ventricle
Sinus
venosus complete by day 28
 Hypoplastic right/ Left
Abnormalities of heart syndrome

Cardiac Looping
Situs Inversus Totalis Dextrocardia

HRHS
HLHS
Day 27:
Primitive 4 Chamber Heart

Truncus LA
Atrium (A) RA

Conus

AV
BVF

Ventricle (V)

Atrio-ventricular canal (AV)

Bulbo-ventricular flange (BVF)
Day 30
Primitive 4 Chamber Heart

superior
Bulbo-
ventricular
flange

R LA R LA
A
A
Common
AV canal

RV LV

AV canal RV LV

inferior

1) two atria,
2) two ventricles, • AV canal begins to migrate to the right
3) a common AV canal. • The bulboventricular flange regresses
Day 35
Atrial Septation

Common AV canal

CAV LA Septum primum

Endocardial R
Cushions A
Ostium primum
anterior

Endocardial Cushion

posterior
RV LV

LAV RAV

Endocardial Cushion
End of the 4th week Atrial Septation
Primary septum Ostium
(atrophies in upper Septum secundum
part) secundum
Ostium
Septum
spurium primum

SVC Pulmonary
veins
LVV
Septum
primum SVC

RVV

IVC

Coronary From pulmonary vein tissue

sinus
Foramen ovale From sinus venosus tissue
Right venous valve (RVV) Valve of
Left venous valve (LVV) foramen ovale
 Fetal Circulation

• Umbilical vein

• Ductus venosus

• Inferior vena cava • Pulmonary vein

FO
• Right atrium • Left atrium

• Right ventricle • Left ventricle

DA
• Pulmonary a. • Aorta

• Right and left • Aorta

Pulmonary artery
 Malformation of Atrial Septum
Probe patent foramen ovale
 Ventricular Septation

Endocardial
cushion

Primary Secondary
nterventricula Interventricular
interventricular
r septum
foramen
foramen
Ventricular Septum Defects
 Septation of Bulbus Cordis
Truncal (Conal) swelling Aorticopulmonary
septum

Bulbus Cordis
Aorta Pulmonary
artery

Anterior

1
2
3
1 2 3
 Transposition of Great Vessels
Transposition of the great vessels HRHS with pulmonary valvular atresla
Persistent Truncus Arteriosus
 Tetralogy of Fallot

(1)a narrow right ventricular outflow region,

pulmonary infundibular stenosis;

(2)a large defect of the interventricular septum;

(3)an overriding aorta that arises directly above

the septal defect;

(4)hypertrophy of the right ventricular wall

because of higher pressure on the right side.
Atrioventricular Valves
Malformation of Aortic Valve
Tricuspid Atresia Ebstein anomaly
 Conduction System of Heart

From SHF
bulboventricular tissue Peripheral ventricular conduction system

Initial
heart atrioventricular tissue Atrioventricular node and bundle
myocard
ium Cx45, Cx30, Tbx3

sinoatrial tussue Sinoatrial node

Tbx18 Tbx3 CX40, Cx43, Nppa, ScnSa (SA node genes)

Vasculogenesis and Angiogenesis
 Development of Arteries and Veins

Development of
Arteries:

1) Aortic arches

2) Dorsal aortae

Development of veins:

1) Vitelline veins
2) Umbilical veins
3) Cardinal (body) veins
Aortic Arches
Derivatives of Aortic Arches
Contribution:

1st aortic arch – maxillary artery

2nd aortic arch – hyoid and stapedial aa.

3rd aortic arch – common carotid and first part

of internal carotid a.

4th aortic arch – on the left side arch of the aorta,

on the right – right subclavian artery

5th aortic arch – never develops

6th aortic arch – pulmonary arteries (right, left),

ducts arteriosus (on the left).
 Coarctation of Aorta

Preductal type Postductal type

Abnormal Origin of Right Subclavian Artery
Double Aortic Arch
Vitelline and Umbilical Arteries
 Development of SVC
Distal parts of both anterior cardinal veins r/l brachio-
Internal
(ACV) form all the major veins of head and cephalic veins
upper limb.
ACV Subclavian vein jugular vein

Proximal part of the right ACV develops

into SVC.
Sinus
Proximal part of the left ACV degenerates venosus
after formation of left-to-right shunt – the Ex.
thymicothyroid anastomosis. jug. v Coronary sinus

CCV
The right posterior cardinal vein (PCV) SVC
becomes the azygos vein
Azygos vein
Thymicothyroid
The left PCV contributes to the formation
anastomosis
of the coronary sinus. PCV
 Development of IVC
IVC develops from
4 portions:

1. renal

2. hepatic

3. vitelline

4. postrenal
 Venous System Defects

Double inferior vena cava Absent inferior vena cava Left SVC Double SVC
5th week Development of Portal Vein

Ductus venosus Ligamentum

Vitelline vein derivatives: foregut venosum

• Hepatic sinusoids;
• Portal vein; liver
• Superior mesenteric vein

Left umbilical vein remnants:

• ligamentum teres hepatis;

• ligamentum venosum (from
ductus venosus). Vitelline veins
Umbilical veins
Ligamentum
Umbilical vein teres
Susceptible Stages for the Induction of Cardiac Birth Defects
 Summary
Mesoderm – give rise to cardiac muscle cells and endocardial cells;
Neural crest cells – develop into smooth muscle of outflow tract and cardiac ganglia;
Proepicardium – epicardium and coronary vessels.

Week 3 Week 4 Week 5 Week 6 Week 7