Moderator band radiology

Heart Lorna P.

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

Moderator band radiology

Metrics details. In the right ventricle RV , the septomarginal trabecula SMT arises as a muscular band originating from the interventricular septum IVS at the lower segment of the crista supraventricularis. It forms a functional unit with the moderator band, which attaches to the lateral free wall of the RV [ 1 , 2 ]. Strategically situated between the RV inflow and outflow tracts, the whole unit serves to help emptying blood into the pulmonary trunk during systole. Thus, it should be anticipated that the SMT may undergo changes in RV hypertrophy secondary to chronic pulmonary hypertension. Imaging was performed in two centers; one using 3 T and the other using 1. Short axis cine images were acquired using fast gradient echo technique. End diastolic frames were analyzed using MASS 6. Starting from the basal slices, the SMT was identified in patients and controls as the most anterior trabeculation arising from the IVS below the outflow tract level. Two independent observers manually contoured and traced the SMT from its origin towards the apex where the moderator band and secondary trabeculation arise.

LAleft atrium; RAright atrium.

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.

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.

Moderator band radiology

Federal government websites often end in. The site is secure. The moderator band in the right ventricle is being increasingly recognised as a source for arrhythmias in the absence of identifiable structural heart disease. Because it carries part of the conduction system from the right ventricle septum to the free wall, it is a source of Purkinje-mediated ventricular arrhythmias that manifest as premature ventricular contractions PVC or repetitive ventricular tachycardia. More importantly, short coupled PVCs triggering polymorphic ventricular tachycardia and VF have been localised to the moderator band and ablation of these Purkinje mediated PVCs can effectively prevent recurrent VF. The exact mechanism of arrhythmogenesis is still debated but stretch, fibrosis and ion channel alterations might be responsible. Arrhythmias originating in this region of the right ventricle may thus be another cause for idiopathic VF that is potentially treatable with catheter-based ablation techniques. Recognition of the typical PVC morphology can point to the moderator band as the source of idiopathic VF and an opportunity for timely intervention.

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Axial enhanced CT image shows thickened tricuspid valve with narrowed valve annulus asterisk and hypoplastic right ventricle RV. The ostium secundum results from small perforations, which form in the septum primum and which gradually coalesce. Cardiac MRI can evaluate the presence and location of the ASD, which is close to the tricuspid and mitral valves in ostium primum defects, midinteratrial septum in ostium secundum defects, and posterior aspect of cavoatrial junction in sinus venous defects. CO;2-H - Pubmed. LPA , left pulmonary artery. However, these papillary muscles are more variable in appearance than moderator band in terms of correctly identifying ventricular morphology. This starts in the roof of the primitive common atrium and grows toward the endocardial cushions, located between the primitive atria and ventricles. Spin-echo black blood techniques allow a static overview of the extracardiac thoracic vasculature. Corresponding author. Ann Thorac Surg. Add cases to playlists Share cases with the diagnosis hidden Use images in presentations Use them in multiple choice question Creating your own cases is easy.

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Imaging was performed in two centers; one using 3 T and the other using 1. Types 2 and 3 were the most common, appearing in 15 Spin-echo black blood techniques allow a static overview of the extracardiac thoracic vasculature. In addition, screening for venovenous or aortopulmonary collateral vessels should be performed. Sorry, a shareable link is not currently available for this article. The RV has a number of prominent trabeculations along the septum and ventricular free wall. The first step is the evaluation of visceral situs. Chronic left-to-right shunting may result in pulmonary hypertension leading to reversal of shunting known as Eisenmenger syndrome. Computed Tomography Previously, pediatric cardiac computed tomography angiography CTA was associated with relatively long acquisition times and high radiation doses, limiting its utility in pediatric cardiac imaging. Additional views, such as left and right outflow tract planes as well as aortic root planes Fig. Chest radiography usually demonstrates cardiomegaly, and in patients with subaortic stenosis, the pulmonary vascularity is increased. Bright blood magnetic resonance image in left ventricular outflow tract plane shows mitral valve leaflets asterisks prolapsing into the left atrium LA with a prominent regurgitant jet arrow.