Type of Article:  Original Research

Volume 6; Issue 3.1 (July 2018)

Page No.: 5458-5463

DOI: https://dx.doi.org/10.16965/ijar.2018.238


Shrikanya M Shet *1, Kuldeep M D 2, Sheela G Nayak 3, V S Pare 4, Jyothi S R 5 , M P Shenoy 6.

*1 Student, 1st MBBS, K V G Medical College, Sullia, Rajiv Gandhi University Of Health Sciences, Karnataka.

2 Student, 1st MBBS, K V G Medical College, Sullia, Rajiv Gandhi University Of Health Sciences, Karnataka.

3 Dean Academics, K V G Medical College, Sullia, Rajiv Gandhi University Of Health Sciences, Karnataka.

4 Professor and HOD, Department Of Anatomy, K V G Medical College, Sullia, Rajiv Gandhi University Of Health Sciences, Karnataka.

5,6 Assistant Professor, Department Of Anatomy, K V G Medical College, Sullia, Rajiv Gandhi University Of Health Sciences, Karnataka.

Address for Correspondence: Shrikanya M Shet, 1st MBBS, K V G Medical College, Kurunjibhag, Sullia, Dakshina Kannada, Karnataka, India.

E-Mail:  shrikanyasagar99@gmail.com


Background and objectives: Moderator band is a specialized bridge present between the base of the anterior papillary muscle and interventricular septum. It carries the right branch of the bundle of HIS with it. The band is known to prevent the over distension of the right ventricle during the diastolic phase. There is a need of lot of research and studies on the septomarginal trabecula as it proves to be important clinically. Here we measured the length, breadth, height, angle with the interventricular septum, and the superficial marking of Moderator band on the sternocostal surface of the right ventricle is done. This paper describes the morphological variations found in its origin and insertion.

Materials and Methods:  15 formalin-soaked cadaveric hearts were taken from the Department of Anatomy of KVG Medical College, Sullia. The foetal hearts, the hearts with gross pathology, if any are excluded from the study.

Result: The morphometric parameters are tabulated and the morphological variations are noted. The results are compared with the results of the previous studies on the moderator band.

Conclusion:  It is confirmed that the thickness of moderator band varies at its origin and insertion. The surface marking of moderator band on sternocostal surface of the heart will help in locating the moderator band through the echocardiography and during cardiac surgeries on right ventricle. The possibility of second moderator band, multiple origin or insertion is more than 20%.

Key words:  Septomarginal trabecula, Surface marking, Right ventricle, Moderator Band.


  1. Peter L Williams: Grays Anatomy. 39th edition, Churchill Living stone. 2005, pp 1002-1003.
  2. King T.W. An essay safety-valve function in the right ventricle of the human heart and the gradations of this function in the circulation of warmed-blooded animals. Guy’s Hosp. Rep. 1837;2:104-178.
  3. Tandler J. Anatomie des Herzens [German] Gustav Fischer, Jena. 1913; 1-3
  4. S Y Ho, P Nihoyannopoulos. Anatomy echocardiography and normal right ventricular Dimensions Heart. 2006; 92(Suppl l):2–13.
  5. Kosiñski A, Grzybiak M, Nowiñski J, Kêdziora K, Kuta W, Dbrowska-Kugacka. Morphological remarks regarding the structure of conduction system in the right ventricle. Kardiol Pol. 2012; 70(5):472-476.
  6. Geoffrey Farrer-Brown, Vascular Pattern of Myocardium of Right Ventricle of Human Heart. Brit. Heart J., 1968:30:679.
  7. Reig J, Albertí N, Petit M. Arterial vascularization of the human moderator band: an analysis of this structure’s role as a collateral circulation route. Clin Anat. 2000; 13(4):244-50.
  8. H M Haupt, G M Hutchins, G W Moore. Right ventricular infarction: role of the moderator band artery in determining infarct size. Circulation. Jun 1983; 67(6):1268-72.
  9. Sadek MM, Benhayon D, Sureddi R, Chik W, Santangeli P, Supple GE et al. Idiopathic ventricular arrhythmias originating from the moderator band: Electrocardiographic characteristics and treatment by catheter ablation. Heart Rhythm. 2015 Jan. 12(1):67-75.
  10. SR Mittal. Moderator Band Wrongly Interpreted as RV Mass. JAPI. August 2012; 60:1-3.
  11. Wong PC, Sanders SP, Jonas RA, Colan SD, Parness IA, Geva T et al. Pulmonary valve moderator band distance and association with development of double-chambered right ventricle. The American journal of cardiology. 1991 Dec 15; 68(17):1681-6.
  12. Haddad F, Couture P, Tousignant C, Denault AY., The right ventricle in cardiac surgery, a perioperative perspective: II. Pathophysiology, clinical importance, and management Anesth Analg. 2009 Feb; 108(2):422-33.
  13. Turner. Moderator Band in Left Ventricle and Tricuspid Left Auriculo-Ventricular Valve. J Anat Physiol. 1898 Apr; 32(Pt 3):373–376.
  14. Loukas M, Klaassen Z, Tubbs RS, Derderian T, Paling DA, Chow D, Patel S, Anderson RH. Anatomical observations of the moderator band. Clinical Anatomy. 2010 May 1;23(4):443-50.
  15. Richard A Jonas., Comprehensive Surgical Management of Congenital Heart Disease. J R Soc Med. 2004 Aug; 97(8):407–408.
  16. Theodoros Xanthos, Ioannis Dalivigkas, Konstantinos A. Ekmektzoglou. Anatomic variations of the cardiac valves and papillary muscles of the right heart. IJAE 2011; 116(2):111-126.
  17. Praveen Shenoy, Martin Lucas, Vinay KV, Amith Ramos. Morphometric study of septomarginal trabeculae (moderator band). Int J Anat Res 2016;4(4):3302-3308.
  18. Adam Kosiñski, Dariusz Koz³owski, Janusz Nowiñski. Morphogenetic aspects of the septomarginal trabecula in the human heart, Arch Med Sci. 2010 Oct; 6(5): 733–743
  19. Mamatha H, Divya Shenoy, Antony Sylvan D’ Souza, Prasanna LC, Suhani Sumalatha. Morphometric Study on the Septomarginal Trabeculae in South Indian Cadavers. RRJMHS 2013;2 (2):65-70.
  20. Praveen Shenoy M, Martin Lucas A, Morphological and Morhometric study of Septomarginal trabeculae (moderator band). GJRA – GLOBAL JOURNAL FOR RESEARCH ANALYSIS.2018;7(2):451-482.
  21. Raghavendra AY, Kavitha AK, Tarvadi P, Harsha CR. Anatomical study of the moderator band. Nitte University Journal of Health Science. 2013;3(4).

Cite this article: Shrikanya M Shet, Kuldeep M D, Sheela G Nayak, V S Pare, Jyothi S R, M P Shenoy. MORPHOMETRIC AND MORPHOLOGICAL STUDY ON THE SEPTOMARGINAL TRABECULA. Int J Anat Res 2018;6(3.1):5458-5463. DOI: 10.16965/ijar.2018.238