FETAL CARDIAC MORPHOLOGY OF TETRALOGY OF FALLOT WITH ABSENT PULMONARY VALVE IN THE RAT

Fetal in situ cardiovascular and bronchial morphologies were studied in rats with tetralogy of Fallot and absent pulmonary valve to clarify the prenatal pathology of this complex. There were 42 fetal rats with this complex among 300 fetuses treated with N,N'-bis-(dichloroacetyl)-1,8-octamethylenediamine (bis-diamine) (200 mg) on the 10th day of pregnancy. After undergoing rapid whole-body freezing on the 21st day, they were studied by means of serial cross-sectional photographs of the frozen thorax. Fetuses with normal heart treated with bis-diamine served as control. Tetralogy of Fallot and absent pulmonary valve in the fetus was associated with absence of the ductus arteriosus, enlargement and hypertrophy of both ventricles, and enlargement of the pulmonary arteries that compressed the bronchial trees. These abnormalities were inversely correlated with the degree of pulmonary stenosis. Milder stenosis (pulmonary valve ring >50% of control, n = 28) was associated with larger pulmonary arteries (250 ± 12% of control) (mean ± SEM) and larger ventricles (volume, 200 ± 15%; mass, 130 ± 4%). Severe stenosis (pulmonary valve ring <50% of control, n = 14) was associated with mildly enlarged pulmonary arteries and mild bronchial compression. We concluded that enlargement of the pulmonary arteries and bronchial compression develop in fetal life and are associated with mild pulmonary stenosis in tetralogy of Fallot and absent pulmonary valve.