Fossa ovalis (heart)

Function

During fetal development, the foramen ovale allows blood to pass from the right atrium to the left atrium, bypassing the nonfunctional fetal lungs while the fetus obtains its oxygen from the placenta. A flap of tissue called the septum primum acts as a valve over the foramen ovale during that time. After birth, the introduction of air into the lungs causes the pressure in the pulmonary circulatory system to drop. This change in pressure pushes the septum primum against the atrial septum, closing the foramen. The septum primum and atrial septum eventually fuse together to form a complete seal, leaving a depression called the fossa ovalis. By age two, about 75% of people have a completely sealed fossa ovalis. An unfused fossa ovalis is called a patent foramen ovale. Depending on the circumstances, a patent foramen ovale may be completely asymptomatic, or may require surgery. The limbus of fossa ovalis (annulus ovalis) is the prominent oval margin of the fossa ovalis in the right atrium. It is most distinct above and at the sides of the fossa ovalis; below, it is deficient. A small slit-like valvular opening is occasionally found, at the upper margin of the fossa, leading upward beneath the limbus, into the left atrium; it is the remains of the fetal aperture the foramen ovale between the two atria.

Closure

Almost immediately after the infant is born, the foramen ovale and ductus arteriosus close. The major changes that are made by the body occur at the first breath (in the case of heart and lung functions) and up to weeks after birth (such as the liver's enzyme synthesis). The foramen ovale becomes the fossa ovalis as the foramen closes while edge of the septum secundum in right atrium becomes the anulus ovalis, so the depression beneath it becomes the fossa ovalis. This enables respiration and circulation independent from the mother's placenta.

With the child's first breath, the lung sends oxygenated blood to the left atrium. As a result, pressure in the left atrium is higher than that of the right, and the increased pressure holds the interatrial flap (which covers the foramen ovale) shut, therefore closing the foramen ovale as well. In normal development, the closed foramen ovale fuses with the interatrial wall. During the first breath, vasoconstriction causes the ductus arteriosus to close, and during adult years, tissue occludes what once was the ductus arterious, creating the ligamentum arteriosum.