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The yellow arrow points to the moderator band in the right ventricle.
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.
2 case question available
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.e. in some forms of congenital heart disease).
The term "septomarginal" is descriptive since the muscle extends from the interventricular septum to the margin of the right ventricle, contacting/joining the base of the anterior tricuspid papillary muscle.
The moderator band does not attach to a tricuspid valve, but acts as part of the electrical conduction pathway of the heart -- part of the right bundle branch.
- Anatomy of the Heart at Multidetector CT: What the Radiologist Needs to Know James P. O’Brien, Monvadi B. Srichai, Elizabeth M. Hecht, Daniel C. Kim, Jill E. Jacobs RadioGraphics, 2007, Vol.27: 1569-1582,
- Hurst's The Heart, 13e, Chapter 4. Valentin Fuster, Richard A. Walsh, Robert A. Harrington.
- Anatomic Pitfalls of the Heart and Pericardium Lynn S. Broderick, Gregory N. Brooks, Janet E. Kuhlman RadioGraphics, 2005, Vol.25: 441-453