Type of Article: Original Research
Year: 2015 | Volume 3 | Issue 4 | Page No. 1741-1744
Date of Publication: 31-12-2015
MORPHOMETRIC AND CLINICAL ANALYSIS OF MODERATOR BAND IN HUMANS
HannahSugirthabai RajilaRajendran *1, Ashok Victor 2, Gnanasundaram Vaithianathan 3, Indumathi Sundaramurthi 4, Thotakura Balaji 5, Janani Yoganandham 6.
*1 Professor, Department of Anatomy, Chettinad Hospital & Research Institute, Kelambakkam, Chennai, Tamil Nadu, India.
2 Assistant Professor, Department of Cardiology, Stanley Medical College, Chennai, Tamil Nadu, India.
3 Assistant Professor, Department of Anatomy, Chettinad Hospital & Research Institute, Kelambakkam, Chennai, Tamil Nadu, India.
4 Professor and HOD, Department of Anatomy, Chettinad Hospital & Research Institute, Kelambakkam, Chennai, Tamil Nadu, India.
5 Professor, Department of Anatomy, Chettinad Hospital & Research Institute, Kelambakkam, Chennai, Tamil Nadu, India.
6 Assistant Professor, Department of Cardiology, Stanley Medical College, Chennai, Tamil Nadu, India.
Address: Dr. HannahSugirthabai RajilaRajendran, M.S, Ph.D, Professor, Department of Anatomy, Chettinad Hospital & Research Institute, Kelambakkam, Chennai, Tamil Nadu, India. Pin – 603103 Phone No.: +919710403803
Background: The moderator band has the right bundle of His within the right ventricle. It also is known to prevent the over dilatation of RV. It is important because of its involvement in RV infarcts, in differentiating RV from LV in congenital anomalies, in VPDs & VTs and in VSDs. The present literature is very much lacking in its morphometry.
Materials and Methods: Moderator band was looked for in 50 hearts and only in this study did we find it in all the hearts. The length, the thickness, the distance from the tricuspid valve along with the presence of any trabeculations in the septal end or in the papillary muscle end were looked for and recorded.
Results: The average length was 14.71±4.99mm, the average thickness was 4.97±1.64 mm, the average distance from the tricuspid orifice was 19.85±5.92 mm. The attachment to the anterior papillary muscle was found to be branched in 8 hearts that is having an incidence of 14%. The septal end were branched and separated as two in only two specimens. Only one specimen had branched attachments on both the apical and septal ends.
Conclusion: The distance from tricuspid valve and knowledge of branching are important in corrective surgeries of the VSDs. An awareness of length and thickness helps the clinician to differentiate moderator band from the other structures, which may result in misdiagnosis during echocardiography. Its presence may in fact be of significance in preventing over distension of the heart in RV myocardial ischaemia.
KEY WORDS: Moderator Band, Right Ventricle, Anterior Papillary Muscle, VSD, Tricuspid Valve.
- Susan Standring, Gray’s Anatomy, 40th edition , Churchill Livingstone, Elsevier.
- Paul Ravindran, Solomon Victor. The moderator band, Indian Journal of Thoracic and Cardiovascular surgery, October 1982;1(1):15-21.
- Mathada V Ravishankar. A brief observational study of septomarginal trabaculae in cadavers: original research Int. J. Pharm. Med. & Bio. Sc. 2013;2(3):13-17.
- Haupt HM, Hutchins GM, Moore GW. Right ventricular infarction: role of the moderator band artery in determining infarct size. Circulation. 1983;67(6):1268-1272.
- Virginia D. Winn, Joy Sonson ,Roy A. Filly. Echogenic Intracardiac Focus: Potential for Misdiagnosis, J Ultrasound Med. 2003;22:1207-1214.
- Andre Keren, Margaret E. Billingham, Richard L. Popp. Echocardiographic Recognition of Paraseptal Structures, JACC Vol. 6, No.4. October 1985:913-9.
- Richard van praagh, Tal Geva, Jacqueline Kreutzer. Ventricular Septal Defects: How Shall We Describe, Name and Classify Them?. JACC.1989:1298-9.
- Catherine. M. Otto. The practice of clinical echocardiography, 3rd edition Philadephia, Saunders, 2007, pg 895.
- Nicola Galea, Iacopo Carbone, David Cannata, Giuseppe Cannavale, Bettina Conti, Roberto Galea, Andrea Frustaci,Carlo Catalano, and Marco Francone. Right ventricular cardiovascular magnetic resonance imaging: normal anatomy and spectrum of pathological findings, Insights Imaging. 2013 Apr;4(2):213–223, doi: 10.1007/s13244-013-0222-3.
- Mamatha H, Divya Shenoy, Antony Sylvan D’ Souza, Prasanna LC, and Suhani Sumalatha. A Morphometric Study on the Septomarginal Trabeculae in South Indian Cadavers, Research and Reviews: Journal of Medical and Health Sciences RRJMHS 2013;2(2):65-70.
- Marios Loukas,Zachary Klaassen, R. Shane Tubbs,Trevor Derderian, Dan Paling, Drin Chow, Shilpa Patel and Robert H. Anderson. Anatomical observations of the moderator band. Clinical Anatomy 2010;23(4):443–450. DOI: 10.1002/ca.20968.
HannahSugirthabai RajilaRajendran, Ashok Victor, Gnanasundaram Vaithianathan, Indumathi Sundaramurthi, Thotakura Balaji, Janani Yoganandham. MORPHOMETRIC AND CLINICAL ANALYSIS OF MODERATOR BAND IN HUMANS. Int J Anat Res 2015;3(4):1741-1744. DOI: 10.16965/ijar.2015.342