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The fetal heart contains two upper atria and two lower ventricles. It also contains two additional structures, the foramen ovale and the ductus arteriosus, that function as shunts for oxygenated blood. [2] The function of these shunts is to bypass the lungs and maintain proper circulation to
It is one of two fetal cardiac shunts, the other being the ductus arteriosus (which allows blood that still escapes to the right ventricle to bypass the pulmonary circulation). Another similar adaptation in the fetus is the ductus venosus. In most individuals, the foramen ovale closes at birth. It later forms the fossa ovalis.
The pulmonary circulation loop is virtually bypassed in fetal circulation. [7] The fetal lungs are collapsed, and blood passes from the right atrium directly into the left atrium through the foramen ovale (an open conduit between the paired atria) or through the ductus arteriosus (a shunt between the pulmonary artery and the aorta). [7]
Ductus arteriosus evolved with the lung in the ancestors of the lungfish as a connection between the pulmonary arteries and dorsal aorta. During embryonic development, reptiles, birds, and mammals all have either one or two paired ductus arteriosi that provide a fetal shunt of blood away from the lungs.
In many cases, TGV is accompanied by other heart defects, the most common type being intracardiac shunts such as atrial septal defect including patent foramen ovale, ventricular septal defect, and patent ductus arteriosus. Stenosis, or other defects, of valves and/or vessels may also be present. [citation needed]
The foramen secundum and foramen ovale act as a shunt where blood bypasses the lungs and does not become oxygenated. To provide proper blood flow as a newborn, the foramen secundum and foramen ovale must close at birth. Since the lungs now require a significant amount of blood flow, the vessels going to and from the lungs undergo dilation.
In adults, the ligamentum arteriosum has no useful function. It is a vestige of the ductus arteriosus, a temporary fetal structure that shunts blood from the pulmonary arteries to the aorta. This significantly reduces the volume of blood circulating through the lungs, which are inactive in the womb.
A catheter may be inserted into one of the umbilical arteries of critically ill babies for drawing blood for testing. [6] This is a common procedure in neonatal intensive care, and can often be performed until 2 weeks after birth (when the arteries start to decay too much). [7]