Moderator band radiology

Heart Lorna P. Browne Edward Y. Lee Oleksandr Kondrachuk Marielle V. Fortier Zhu Ming Cynthia K.

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.

Moderator band radiology

The moderator band also known as septomarginal trabecula [1] is a band of cardiac muscle found in the right ventricle of the heart. It extends from the base of the anterior papillary muscle of the tricuspid valve to the ventricular septum. The moderator band is located in the right ventricle. The moderator band is important because it carries part of the right bundle branch of the atrioventricular bundle of the conduction system of the heart to the anterior papillary muscle. The moderator band is often used by radiologists and obstetricians to more easily identify the right ventricle in prenatal ultrasound. From its attachments it was thought to prevent overdistension of the ventricle , and was named the "moderator band". It was first described by Leonardo da Vinci in his exploration of human anatomy. Contents move to sidebar hide. Article Talk. Read Edit View history.

LPAleft pulmonary artery. The moderator band also known as septomarginal trabecula [1] is a band of cardiac muscle found in the right ventricle of the heart.

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.

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. Articles: Right ventricle Congenital heart disease in echocardiography an approach Arrhythmogenic right ventricular cardiomyopathy Point-of-care ultrasound curriculum Intracardiac thrombus Papillary muscles Four chamber cardiac view fetal Cases: Moderator band Pulmonary atresia with ventricular septal defect and situs inversus totalis. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Edit article. Citation, DOI, disclosures and article data. Moderator band. Reference article, Radiopaedia. Article created:.

Moderator band radiology

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.

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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. Several types of bands are incidental findings discovered at imaging and do not produce clinical symptoms. This procedure sacrifices the MPA in order to refashion an ascending aorta capable of sustaining the systemic arterial supply. The AV bundle of HIS runs through the membranous septum and is the only normal route for connection between the AV node and the ventricular myocardial conduction system. Moderator band Right ventricle. In this situation, the coronary arteries also rely on retrograde flow leading to chronic myocardial hypoperfusion. Circulatory system Coronary circulation Coronary arteries. Anatomy of the heart. Two independent observers manually contoured and traced the SMT from its origin towards the apex where the moderator band and secondary trabeculation arise. 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. Occasionally, annular plication is used in severe mitral valve prolapse with redundant leaflets. Present study

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.

Anatomical terminology [ edit on Wikidata ]. Axial bright blood magnetic resonance image shows turbulent jets arising from the tips of stenosed mitral valve leaflets arrows. There are four types of VSDs that reflect the embryologic development of the interventricular septum: inlet, muscular, perimembranous, and subarterial 17 Fig. The moderator band is important because it carries part of the right bundle branch of the atrioventricular bundle of the conduction system of the heart to the anterior papillary muscle. Corresponding author. Articles: Right ventricle Congenital heart disease in echocardiography an approach Arrhythmogenic right ventricular cardiomyopathy Point-of-care ultrasound curriculum Intracardiac thrombus Papillary muscles Four chamber cardiac view fetal Cases: Moderator band Pulmonary atresia with ventricular septal defect and situs inversus totalis. Download as PDF Printable version. Then the right atrium expels blood through the tricuspid valve into the RV. Type 3 was divided into subtypes based on their length Table 1. The trabecular portion contains prominent muscle bundles that traverse the chamber from the free wall to the interventricular septum and include the moderator band. Anatomy of the heart at multidetector CT: what the radiologist needs to know. The right ventricle wall attachment of the moderator band joins the base of the anterior tricuspid papillary muscle. The tricuspid valve is downwardly displaced and adherent to the interventricular septum. Case study, Radiopaedia.