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Morphometric analysis of fossa ovalis in rheumatic heart disease

Rohan G Chaudhari1, Sweety V Shinde, Jaya R Deshpande

  • 1Department of Pathology, BYL Nair Hospital and TN Medical College, Mumbai.

Indian Heart Journal
|March 9, 2006
PubMed

Insights

Rheumatic heart disease alters the interatrial septum and fossa ovalis, increasing their size and causing horizontal orientation. These morphometric changes in fossa ovalis are crucial for safe transseptal catheterization.

Area of Science:

  • Cardiovascular Pathology
  • Cardiac Anatomy
  • Interatrial Septum Morphology

Background:

  • Rheumatic heart disease (RHD) is a significant cause of valvular disease in India.
  • RHD leads to characteristic alterations in the interatrial septum and fossa ovalis.
  • Understanding fossa ovalis morphometrics is vital for preventing complications during transseptal catheterization.

Purpose of the Study:

  • To investigate the morphometric changes in the interatrial septum and fossa ovalis in patients with rheumatic heart disease.
  • To compare these dimensions between RHD patients and a control group.
  • To assess the potential implications for transseptal catheterization procedures.

Main Methods:

  • Autopsy heart specimens from 30 RHD patients (cases) and 30 non-cardiac death controls (15-45 years) were analyzed.
  • Measurements included the dimensions of the fossa ovalis and interatrial septum.
  • The ratio of fossa ovalis area to septal area was calculated, and fossa orientation was assessed.

Main Results:

  • RHD cases showed significantly increased septal and fossa ovalis surface areas compared to controls.
  • Septal area enlargement was noted in both 15-30 and 31-45 year age groups, particularly in females aged 15-30.
  • Fossa ovalis area increased only in the 31-45 year age group, with a significant horizontal orientation observed in RHD cases, especially females aged 15-30.

Conclusions:

  • Septal area enlargement in RHD begins early, coinciding with initial hemodynamic and valvular changes.
  • A distinct horizontal orientation of the fossa ovalis is characteristic of RHD.
  • Morphological variations in fossa ovalis and septum dimensions depend on the dynamics of stenotic and regurgitant valves.
Abstract

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