View source for Paper - The frequency of an opening between the right and left auricles at the seat of the foetal foramen ovale (1900)

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| [[File:Mark_Hill.jpg|90px|left]] This historic 1900 paper by Fawcett described development of the human heart foramen ovale.
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'''Modern Notes:''' {{foramen ovale}}

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[https://www.ncbi.nlm.nih.gov/pubmed/?term=foramen+ovale+development Search PubMed foramen ovale development]
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=The Frequency of an Opening between the Right and Left Auricles at the seat of the Foetal Foramen Ovale=
[[File:Edward Fawcett.jpg|thumb|150px|link=Embryology History - Edward Fawcett|alt=Edward Fawcett|Edward Fawcett]]

By [[Embryology History - Edward Fawcett|Prof. E. Fawcett]], Univ. Coll., Bristol, and Dr J. V. BLacurorp, City and County Asylum, Bristol.


This is an investigation commenced two years before the subject was taken up by the Anatomical Society. As the report of that Society was issued long before our investigation could lead us to any conclusion worth recording, we have used that report as a convenient standard for comparison ; and as that report deals with 399 cases, and we have dealt with 306 cases, we are, by combining the two, able to present conclusions based on examinations of 705 hearts.


We ourselves have not examined any hearts of which the age was under ten years, as all the examinations were made in the post-mortem room of the Bristol Asylum. In all, we examined 306 hearts, 173 of which were from males and 133 were from females. We found that out of 306 specimens there was a patent foramen ovale in 96 (31°37 per cent.). In 173 male hearts there was a foramen in 51 (29°47 per cent.). In 133 females the foramen was met with 45 times (33°83 per cent.). Giving these figures in table we get — |

===Table I. — Frequency of Patent Foramen Ovale===

1. In all cases (306)  96 = 31.37 per cent. 
2. Inmales (173)  51 = 29.47
3. In females (133)  45 = 33.83

One might conclude that patency was more common in females than males from this table, and as a matter of fact that conclusion is drawn in the Anatomical Society’s report. We leave that an open question, as in both cases the number of females examined is less than that of males, and our experience is that accurate conclusions can only be drawn when the numbers coincide.

We next give a table comparing our results with those of the Anatomical Society, the results of the latter being given in brackets.

===Table Ia.===

Cases, Combined. Percentage. Combined. 1. In all cases, 306 (399) = 705 .... 31:37 (26) = 28°36 2. In males, 173 (248) = 421... . 29°47 (24:2) = 26°3 3. In females, 133 (151) = 284... . 33°83 (29) = 31:3

We may now consider the effect of age on the patency of the foramen ovale. Here we may say that the age was determined in all cases save one male. In the table subjoined we give the results of our own investigations side by side with that of the Anatomical Society. The Roman letters A.S. indicate Anatomical Society.

===Table II. — Influence of Age on Foramen Ovale===

MALE. FEMALE. Com- Combined bined Age. Cases. Patent. | Percentage. | Per- Cases. | Patent.) Percentage. | Percent- centage. age. A. 8. A. S. A. S. A. 8. AS, | A. 8. 10-20; 3;15 0; 4] O° | 26%6/22'2)) 38/15; 8] 3/100° | 20° | 33°3 20-30; 10 | 20 4 5 | 40° | 25° | 30° 16 | 26 | 6| 6] 387°5| 23° | 28°5 30-40} 88 | 30 | 9] 7 | 23°6 | 23°3 | 23°5 || 20 | 25 | 7| 5] 35° | 20° | 26°6 40-50] 35 | 41 | 10 | 12 | 28°5 | 29°2 | 28°9 || 23 | 31 | 6| 5| 26° | 16°1 | 20°3 50-60] 27 | 35: Il 8 | 40°7 | 22°8 | 30°6 || 27 | 21 | 9} 4] 33:3) 19° | 27°0 60-70; 29 | 29 7 7 | 24°1 | 24° | 2471 || 22 | 12 | 6] 5| 27:2) 41°6 | 32°3 70 | and 30 | 12 9 3; 30° | 25° | 28:5 |; 22 4 | 8] 2] 36°3) 50° | 38°4 over Total, |172 |182 | 50 | 46 Total, !/133 [134 | 45 | 30 eee nee YS -- S end Combined, 354 96 267 75

It must be evident from the above table that little is to be learned from it as regards the effect of age.

We will now examine the influence of age on the foramen ovale in males and females combined. OPENING BETWEEN THE RIGHT AND LEFT AURICLES. 69

===Table III. - Influence of Age on Foramen Ovale in Males and Females combined===

Anatomical Society’s Results.

. Com. | Com
|
Cases. |Patency| Percentage. || Percentage. Perosntane. bined Paten- : cies. 10-20 6 3 , 50° 23°3 27°7 36 10 20-30 | 26 | 10 | : 38°46 24° 29°1 72 | 21 30-40 58 16 | 27°58 21°65 24°7 113 28 40-50 58 16 | 27°58 22°65 25°3 130 33 50-60 54 20 37° 20°9 29° 110 32 60-70 51 13 25°48 32°8 27°1 92 25 7Oand\! 59 | a7 | 326 37°5 32°3 68 | 22

over



From this table we may gather that in cases over 20 years of age, of which there are 585, that a patency may be expected in 27°3 per cent. of cases; the Society’s report gives 19°5 per cent.

Let us now turn our attention to the size of the opening.

In all, we are able to record 74 cases in which the size was measured.

The results may be shown in the following table :—

===Table IV. — Size of the Opening between Auricles===
{|
! width=200px|Measurement
! width=200px|Cases
! width=200px|Percentage
|-
| Under 2 mm
| 16
| 21.6
|-
| Over 2 mm
| 8 
| 10.8
|-
| 2.5
| 6
| 8.1
|-
| 3
| 3
| 4
|-
| 4
| 2
| 2.7
|-
| 5 
| 10
| 13.51
|-
| 6
| 17
| 22.97
|-
| 7
| 8
| 10.81
|-
| 12
| 2
| 2.7
|-
| 15
| 2 2.7
|-
| Average size, 4.6.
| Total 74
|
|}

In the report of the Anatomical Society the measurement is not taken over 1 centimetre, but for sake of comparison we will group our cases of 8 millimetres and over with that of the Society of 1 centimetre and over, as in the following table :—

TaBLE V. — Size of Opening between Auricles—Combined Results.

Measurement. Cases. Percentage. A. S. A. 8. Under 2mm.,| 16 11 = 27 | 21°6 | 13: = 17° per cent. Over 2° ,, 8 11 = 19 10°8 | 13° = 12°2 ” 5, 25 ,, 6 11 = 17 8°1 | 13° = 107 ” 9» «8° ogy 3 7 = 10 4° 8°2 = 6°3 9 9 4: 29 2 3 = 5 2°7 3°5 = 3°1 » » 8 5, 10 17 = 27 13°5 | 20° = 17° ” » & ,, 17 7 = 24 22°9 8°2 = 15:1 ” 99 Fogg 8 3 = Ill 10°8 3°5 = 6° 9 8 and over, 4 14 = 18 5°4 | 16°6 = 113 » Total,. . 74 84

158

==General Conclusions==

1. That a patent foramen ovale exists in 284 per cent. of cases. 2. That it may possibly occur more frequently in the female than the male. 3. That its size varies from 1 to 15 mm., but the most frequent sizes are— (a) Under 2 mm. (6) Over 5 mm. (c) Over 6 mm. but under 7 mm.

In two cases there could have been no valvular closing of the foramen; in fact, no valve existed; both were 15 mm. in diameter, and no sign or symptom showed itself during life.

As this investigation was undertaken with the prime object of determining the frequency of patency of the foramen, we make no remark as to the site or as to the character of the annulus; that, we propose to relegate to a future occasion.

We append a note as to the character of the opening as observed in 50 males and 45 females :——

In males, 50 cases.

Single, 46 = 92 per cent. Double, 3 = 6.1 Quadruple, 1 = 2.1

In females, 45 cases. Single, 43 = 95.5 Triple, 1 = 2.2 Foenestrated, 1 = 2.2

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[[Category:1900's]]
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