Inflow Tract Development
The development of the venous pole of the heart is undoubtedly one of the most complex remodeling events during the formation of the 4-chambered heart. It involves the creation of two separate atrial chambers, the development of the atrial/atrioventricula
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Inflow Tract Development Andy Wessels
Contents 5.1 5.2 5.3
Introduction Structures Found at the Venous Pole Development of the Venous Pole 5.3.1 The Dorsal Mesocardium 5.3.2 The Atrioventricular Cushions 5.3.3 The Primitive Pulmonary Vein 5.3.4 The Sinus Venosus 5.3.5 The Dorsal Mesenchymal Protrusion 5.3.6 The Components of the Atrial Septum References
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Abstract
The development of the venous pole of the heart is undoubtedly one of the most complex remodeling events during the formation of the 4-chambered heart. It involves the creation of two separate atrial chambers, the development of the atrial/atrioventricular septal complex, the processes that lead to the incorporation of the pulmonary venous return to the left atrium, and the incorporation of the caval veins and coronary sinus into the right side of the heart. In many of these processes, the dorsal mesenchymal protrusion, a derivative of the second heart field, plays a crucial role.
A. Wessels Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, South Carolina, USA e-mail: [email protected] © Springer-Verlag Wien 2016 S. Rickert-Sperling et al. (eds.), Congenital Heart Diseases: The Broken Heart: Clinical Features, Human Genetics and Molecular Pathways, DOI 10.1007/978-3-7091-1883-2_5
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5.1
A. Wessels
Introduction
During the initial phase of heart development, the first heart field (FHF; see Chap. 3) provides the cells that form the primary heart tube. In subsequent stages, this tubular structure undergoes remodeling and looping, and during this process the heart grows and extends at both ends by addition of cells from the second heart field (SHF). The addition of SHF cells is especially prominent at the arterial pole of the heart (see Chap. 3). Using mouse models that allow the tracing of SHF-derived cells in the developing heart, it has been demonstrated that the entire outflow tract (OFT), right ventricle, and a significant part of the interventricular septum (IVS) are derived from the SHF [1]. The contribution of the SHF to the venous pole, while clinically very important, is less well documented and will be discussed in more detail below.
5.2
Structures Found at the Venous Pole
Before discussing the events involved in venous pole development, we will first discuss the normal features of this complex anatomical area of the heart. In this chapter we consider the venous pole to be that region of the heart containing cardiovascular structures that receive the blood returning from the rest of the body. These structures include the left atrium, receiving oxygenated blood that returns from the lungs via the pulmonary veins, and the right atrium that collects deoxygenated blood returning from the rest of the body via the superior and inferior caval vein and the coronary sinus returning deoxygenated blood from the coronary circulation. In a properly formed 4-chambered heart, oxygenated and deoxygenated blood are kept physically separated at atrial level by the atr
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