Premature Closure of Foramen Ovale without Hypoplastic Left Heart Syndrome (An Autopsy Case)

Abstract

An autopsy case is described of a premature closure of the foramen ovale with a marked dilatation of the left atrium and an intact ventricular septum with aortic atresia but without left ventricular hypoplasia. This 28-week-old male baby was a stillborn to a 34-year-old multiparous mother. An intrauterine sonogram revealed marked ascites with anasarca, an enlarged left atrium and ventricle, a small right ventricle and breech presentation. An artificial delivery was done under the impression of congenital heart disease with hydrops fetalis. The heart weighed 20 gm, and the left atrium and ventricle were dilated. The foramen ovale was completely closed with rudimentary fossa ovalis. Fibroelastosis was present in the right atrium and ventricle. Both lungs were trilobed and showed lymphangiectasia. It was presumed that in this case, the premature closure of the foramen ovale was the primary event, and the aortic atresia was secondary.