Location
Moultrie, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Background: The foramen ovale is a physiologic interatrial communication essential to fetal circulation, permitting right-to-left shunting of oxygenated blood to bypass the nonfunctional fetal lungs. Following birth, increased pulmonary circulation and elevated left atrial pressure typically result in functional closure, followed by anatomical fusion of the septum primum and septum secundum within the first year of life. Persistence of this communication into adulthood, termed patent foramen ovale (PFO), occurs in approximately 20–30% of the general population. Although most PFOs are small and clinically silent, larger defects are less common and may carry clinical significance.
Objective: To describe the morphological characteristics and clinical relevance of a large patent foramen ovale identified during routine cadaveric dissection of an elderly female.
Methods: Routine anatomical dissection was performed on the heart of an 81-year-old female cadaver in a medical gross anatomy laboratory. The atria were opened to expose the interatrial septum. Visual inspection was conducted to evaluate septal morphology. Patency of the foramen ovale was assessed by manual manipulation of the septum primum and confirmed by passage of a metal probe between the right and left atria. The maximal diameter of the defect was measured directly using a ruler. Photographic documentation was obtained from multiple angles to verify reproducibility and exclude post-mortem artifacts.
Results: Examination of the interatrial septum revealed a well-defined oval defect located at the site of the fossa ovalis. The opening measured approximately 8–10 mm in maximal diameter and permitted free passage of a probe between the right and left atria, confirming true patency. The septum primum formed a thin, mobile, valve-like flap, and the surrounding septal tissue appeared intact with smooth margins. No evidence of traumatic disruption or additional congenital cardiac abnormalities was observed. The persistence of a defect of this size into advanced age suggests long-term hemodynamic tolerance.
Conclusion: This case documents a large patent foramen ovale in an elderly female cadaver and contributes valuable anatomical evidence of interatrial septal variation. Although many PFOs remain asymptomatic, larger defects may facilitate paradoxical embolism and have been associated with cryptogenic stroke. Cadaveric documentation of large PFOs in elderly individuals remains limited, and this finding underscores the importance of recognizing anatomical variability in both clinical evaluation and anatomical education.
Embargo Period
5-28-2026
Included in
Lack of Standardized Measurement of Patent Foramen Ovale Size Limits Risk Stratification in Cryptogenic Stroke: A Review
Moultrie, GA
Background: The foramen ovale is a physiologic interatrial communication essential to fetal circulation, permitting right-to-left shunting of oxygenated blood to bypass the nonfunctional fetal lungs. Following birth, increased pulmonary circulation and elevated left atrial pressure typically result in functional closure, followed by anatomical fusion of the septum primum and septum secundum within the first year of life. Persistence of this communication into adulthood, termed patent foramen ovale (PFO), occurs in approximately 20–30% of the general population. Although most PFOs are small and clinically silent, larger defects are less common and may carry clinical significance.
Objective: To describe the morphological characteristics and clinical relevance of a large patent foramen ovale identified during routine cadaveric dissection of an elderly female.
Methods: Routine anatomical dissection was performed on the heart of an 81-year-old female cadaver in a medical gross anatomy laboratory. The atria were opened to expose the interatrial septum. Visual inspection was conducted to evaluate septal morphology. Patency of the foramen ovale was assessed by manual manipulation of the septum primum and confirmed by passage of a metal probe between the right and left atria. The maximal diameter of the defect was measured directly using a ruler. Photographic documentation was obtained from multiple angles to verify reproducibility and exclude post-mortem artifacts.
Results: Examination of the interatrial septum revealed a well-defined oval defect located at the site of the fossa ovalis. The opening measured approximately 8–10 mm in maximal diameter and permitted free passage of a probe between the right and left atria, confirming true patency. The septum primum formed a thin, mobile, valve-like flap, and the surrounding septal tissue appeared intact with smooth margins. No evidence of traumatic disruption or additional congenital cardiac abnormalities was observed. The persistence of a defect of this size into advanced age suggests long-term hemodynamic tolerance.
Conclusion: This case documents a large patent foramen ovale in an elderly female cadaver and contributes valuable anatomical evidence of interatrial septal variation. Although many PFOs remain asymptomatic, larger defects may facilitate paradoxical embolism and have been associated with cryptogenic stroke. Cadaveric documentation of large PFOs in elderly individuals remains limited, and this finding underscores the importance of recognizing anatomical variability in both clinical evaluation and anatomical education.
Comments
Presented by George Zakour.