Moderator band radiology

Heart Lorna P. Browne Edward Y. Lee Oleksandr Kondrachuk Marielle V.

The second image shows spatial arrangement of the moderator band and anterior tricuspid papillary muscles. The yellow arrow points to the moderator band, stretching across the right ventricular cavity. The smaller brown arrow points to an anterior papillary muscle underneath. The right ventricle wall attachment of the moderator band joins the base of the anterior tricuspid papillary muscle. Q: How is recognition of the moderator band useful? A: The moderator band is a consistent structure in the right ventricle. When there is a question which ventricle is which e.

Moderator band radiology

Multiple bands and bandlike structures can be found within the cardiac chambers, which can be evaluated with various imaging modalities including echocardiography, CT, MRI, and invasive angiography. These bands can be classified as normal structures or normal variants, aberrant structures, or pathologic entities. Normal structures include the crista terminalis, taenia sagittalis, Chiari network, coumadin ridge, moderator band, papillary muscles, and chordae tendineae. Aberrant structures include aberrant papillary muscles, accessory chordae, false tendons, and accessory mitral valve tissue. Pathologic entities include double-chambered right ventricle, double-chambered left ventricle, cor triatriatum, and subaortic stenosis. Several types of bands are incidental findings discovered at imaging and do not produce clinical symptoms. However, some bands can mimic cardiac diseases, including masses. More importantly, some bands are pathologic entities that produce symptoms owing to hemodynamic consequences. Performing multimodality imaging helps the radiologist a identify, localize, and characterize the bands; b determine if they are normal structures, abnormal structures, or pathologic entities; c distinguish them from cardiac pathologic conditions; and d evaluate the secondary consequences of pathologic entities. This article reviews the various bands visualized within the cardiac chambers, as well as the role of imaging in depicting the bands, their appearances across various imaging modalities, and their clinical significance. Online supplemental material is available for this article. Abstract Multiple bands and bandlike structures can be found within the cardiac chambers, which can be evaluated with various imaging modalities including echocardiography, CT, MRI, and invasive angiography. Publication types Review.

A cleft in the mitral valve can usually be surgically repaired either primarily or with a patch. Morphological classification of the moderator band and its relationship with the anterior papillary muscle. If present, the hypoplastic second ventricular chamber that is not supplied by an AVV is connected to the main moderator band radiology by a VSD.

Federal government websites often end in. The site is secure. This study investigated and classified the various types of moderator band MB in relation to the anterior papillary muscle, with the aim of providing anatomical reference information and fundamental knowledge for use when repairing the congenital defects and understanding the conduction system. The study investigated 38 formalin-fixed human hearts of both sexes obtained from donors aged 38—90 years. The MB was evident in 36 of the 38 specimens The MBs that had a distinct shape were classified into three types according to their shape: cylindrical column, long and thin column, and wide and flat column.

Federal government websites often end in. The site is secure. This study investigated and classified the various types of moderator band MB in relation to the anterior papillary muscle, with the aim of providing anatomical reference information and fundamental knowledge for use when repairing the congenital defects and understanding the conduction system. The study investigated 38 formalin-fixed human hearts of both sexes obtained from donors aged 38—90 years. The MB was evident in 36 of the 38 specimens The MBs that had a distinct shape were classified into three types according to their shape: cylindrical column, long and thin column, and wide and flat column. Types 2 and 3 were the most common, appearing in 15 Type 3 was divided into subtypes based on their length.

Moderator band radiology

As in any other field of radiology, analysis of the acquired images requires a systematic approach. First of all, it is important to understand that the orientation of the heart in the human body differs from that of other anatomic structures: the right ventricle, for example, does not lie completely on the right, but more anterior. The left ventricle does not lie on the left, but more posterior. Also, the heart does not always maintain the same position within the mediastinum - in young people it tends to have a vertical orientation, whereas in older people it tends to rest on the diaphragm, a more horizontal orientation. Cardiologists analyze the heart using cardiac axes.

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After the Fontan procedure, there is usually systemic venous stasis, which is associated with an increased risk of thromboembolism and predisposes to the formation of extensive venous collateral vessels. Check for errors and try again. Anatomic Pitfalls of the Heart and Pericardium. McGraw-Hill Professional. Short axis cine images were acquired using fast gradient echo technique. Diagnosis certain. A small ostium secundum defect may close spontaneously in the first 2 years of life. Septomarginal trabecula with prominent septal portion, septalpapillary portion consisting of a second-order fleshy column, and complex connection to the anterior papillary muscle Axial bright blood magnetic resonance image shows turbulent jets arising from the tips of stenosed mitral valve leaflets arrows. A: Axial enhanced CT image shows mitral valve annular stenosis asterisk and hypoplastic left ventricle LV. Each of these assessments involves dedicated MRI sequences optimized for their individual role. Normally, the RV is anterior and rightward with respect to the LV. Bright blood magnetic resonance image in four-chamber plane demonstrates large atrioventricular septal defect asterisk. This view shows the anterior mitral valve leaflet prolapsing into the atrium during systole with an accompanying regurgitant jet into the left atrium Fig. Bandeira et al.

The moderator band , also called the septomarginal trabecula , is a consistent structure in the morphologic right ventricle and can be helpful as a landmark in situations where the ventricles may be ambiguous i. The moderator band does not attach to the tricuspid valve , but acts as part of the electrical conduction pathway of the heart part of the right bundle branch. Blood supply typically originates from septal perforating branches of the left anterior descending artery LAD which may subsequently anastomose with vessels derived from the right coronary circulation.

The aorta and MPA resected above the level of their valves and translocated to their correct anatomical location with coronary artery reimplantation. These three muscle bands form a circular ring known as the crista supraventricularis, which separates the trabecular portion of the ventricle from the outlet portion. Case study, Radiopaedia. Surgical closure of apical ventricular septal defects through a right ventricular apical infundibulotomy. The interventricular septum first appears as a muscular ridge close to the cardiac apex at the end of the 4th week. The locations where these quadrants overlap are termed anteroseptal, anterolateral, inferoseptal, and inferolateral. Pulmonary outflow tract obstruction may also occur with either concordant or discordant ventriculoarterial connections. In general, adenosine is preferred because of its ease of administration, fast action, and short half-life. Citation, DOI, disclosures and case data. Unable to process the form. Loukas et al. The moderator band does not attach to the tricuspid valve , but acts as part of the electrical conduction pathway of the heart part of the right bundle branch. Then, it grows cephalad as the RV and LV enlarge, eventually fusing with bulbus cordis primitive ventricular outflow tract. Fulton, Harold Goerne.