10 - Patent Foramen Ovale Correlated with Fossa Ovalis Area and Cardiovascular Comorbidities II

Poster Board Number: 10
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Abstract Body : Introduction: Foramen ovale, formed by the overlap of septum primum of the left atrium and septum secundum of the right atrium, is an interatrial septal structure essential for fetal circulation. Most fetal blood flow enters the right atrium and flows through the foramen ovale to the left atrium, bypassing the lungs [1]. Typically, within the first two years of life, septum secundum and septum primum fuse together to form an oval-like structure of the right atrium known as fossa ovalis (FO). Failure of septal closure results in a patent foramen ovale (PFO) which occurs in approximately 25% of the population [1]. Previous studies have associated the presence of PFO with multiple pathologies, including cryptogenic stroke, migraine headaches, platypnea-orthodeoxia syndrome and embolism [2]. Given the clinical significance of pathology related to PFOs, this study assessed the presence of a PFO in relation to the size of the FO, sex, and cardiovascular comorbidities. Objective: We address the correlation between presence of a PFO with area of FO, sex, and cardiovascular comorbidities. Materials and Methods: Seventy-three human cadaver hearts were obtained from Liberty Universities’ anatomy labs from 2017-2022. Measurements of length and width of the FO and measurements of the length of the PFO from both the right and left atria were taken using a Helios analog micrometer. Length was determined as the longest distance across the FO, and width was measured as the distance perpendicular to the length. Cadaver age, sex, cause of death, and comorbidities were collected from the Virginia State Anatomical Program. Cardiovascular disease was defined based on comorbidities of stroke, hypertension, congestive heart failure, coronary artery disease, CABG, AFib, and CADASIL. Statistical analysis was completed using JASP and Python software. Results: The area of the FO was significantly larger in hearts with PFOs than those without PFOs (p=0.0026). No statistically significant difference was found between presence of a PFO and sex [χ2 (df=1, N=73)=0.807, p=0.369] or cardiovascular comorbidities [χ2 (df=1, N=73)=0.322, p=0.570]. However, significantly more male cadavers with a PFO had cardiovascular comorbidities compared to female cadavers with a PFO [χ2 (df=1, N=19)=4.550, p=0.033]. Conclusion: The results show that increased fossa ovalis area positively relates to increased incidence of a patent foramen ovale in cadavers at Liberty. In addition, a higher percentage of males with PFOs had cardiovascular comorbidities than females with PFOs. These findings may provide clinical direction in patients presenting with PFO or related clinically relevant symptoms. Significance: This study demonstrates the importance of an early detection of a PFO in the presence of unexplained cardiovascular comorbidities to reduce comorbidity recurrence and improve quality of life. In the future this study will expand the sample size to confirm these trends and support clinical studies of PFO treatments. References: 1) Kerut E, et al. (2001) Patent foramen ovale: a review of associated conditions and the impact of pathological size. Journal of American College of Cardiology, 38(3) 613-623. https://www.jacc.org/doi/full/10.1016/S0735-1097%2801%2901427-9; 2) Hara H, et al. (2005) Patent foramen ovale: current pathology, pathophysiology, and clinical status. Journal of American College of Cardiology, 46(9), 1768-1776. https://www.jacc.org/doi/full/10.1016/j.jacc.2005.08.038