MORHOMETRIC STUDY OF SEPTOMARGINAL TRABECULAE (MODERATOR BAND) Praveen Shenoy * 1 , Martin Lucas 2 , Vinay KV 3 , Amith Ramos 4 . *1  Post Graduate, Department of Anatomy, K.S. Hegde Medical Academy, Nitte University, Karnataka, India. 2  Professor & HOD, Department of Anatomy, K.S. Hegde Medical Academy, Nitte University, Karnataka, India. 3  Associate Professor, Department of Anatomy, K.S. Hegde Medical Academy, Nitte University, Karnataka, India. 4  Assistant Professor, Department of Anatomy, K.S. Hegde Medical Academy, Nitte University, Karnataka, India. Address   for   Correspondence:   Dr.   Praveen   Shenoy,   Post   Graduate,   Department   of   Anatomy,   K.S.   Hegde   Medical   Academy,   Nitte   University,   Karnataka,   India. Mobile No.: +91 9591422543  E-Mail:   shenoy1100@gmail.com ABSTRACT Background   and   objectives:   Septomariginal   trabeculae   or   Moderator   band   is   a   specialized   bridge   connecting   interventricular   septum   to   the   base   of   the anterior   papillary   muscle.   It   contains   Right   Bundle   branch   of   HIS,   it   is   also   Known   to   prevent   the   over   distension   of   the   right   ventricle.   The   literature   review shows   the   paucity   of   articles   related   to   morphological   and   morphometric   evaluation.   Since   it   has   a   great   clinical   importance   its,   further   studies   become Mandatory.   Here   we   have   measured   the   angle   of   the   Moderator   band   to   its   origin   from   the   interventricular   septum   and   the   anterior   papillary   muscle   is measured. The superficial marking of Moderator band on the sternocostal surface of the right ventricle is marked. Materials   and   Methods:   50   Formalin   soaked   cadaveric   Hearts   were   taken   from   the   department   of   Anatomy   of   KSHEMA.   36   Males   and   14   Female   Hearts were   tagged   according   to   ascending   order   of   the   age.   Moderator   band,surface   marking   on   sterocostal   surface   ,   the   angle   with   the   anterior   papillary   Muscle ect are Noted. Result: The morphological variations are noted. The results are compared with gender, with the previous results . Conclusion:   There   is   a   difference   in   the   course   of   moderator   band.   In   60%the   moderator   band   runs   downwards   and   to   the   right,   in   30%   it   is   found   to   be horizontal   and   in   10%   runs   upwards   and   to   the   right.   The   difference   is   found         in   males   and   females.as   well.   The   surface   marking   of   moderator   band   on sternocostal   surface   of   the   heart   measures   more   due   to   the   convexity   of   the   right   ventricular   surface.   This   knowledge   will   help   in   accurate   detection   of   the moderator band by echocardiography and in surgeries. KEY WORDS: Septomarginal trabeculae, Moderator Band, surface marking, Right ventricle. References 1 . Peter L Williams: Grays Anatomy, 39th edition, Churchill Living stone. 2005, pp 1002-3. 2 . Adam   Kosiński ,   Dariusz   Kozłowski ,    Janusz   Nowiński .   Morphogenetic   aspects   of   the   septomarginal   trabecula   in   the   human   heart,   Arch   Med   Sci.   2010 Oct; 6(5): 733–743.. 3 . Grant   RP,   Downey   FM,   MacMahon   H.   The   architecture   of   the   right   ventricular   outflow   tract   in   the   normal   human   heart   and   in   the   presence   of ventricular septal defects. Circulation. 1961;24:223–35. 4 . Tandler J. Anatomie des Herzens  [German]  Gustav Fischer, Jena.  1913;1-3 5 . S Y Ho, P Nihoyannopoulos. Anatomy echocardiography and normal right ventricular Dimensions Heart. 2006; 92(Suppl  l):2–13. 6 . Kosiński   A  ,   Grzybiak   M ,   Nowiński   J ,   Kędziora   K ,   Kuta   W ,   Dąbrowska-Kugacka      Morphological   remarks   regarding   the   structure   of   conduction   system   in the right ventricle.  Kardiol Pol.  2012;70(5):472-6. 7 . Geoffrey farrer-brown, Vascular Pattern of Myocardium of Right  Ventricle Of Human Heart. Brit. Heart J., 1968:30:679. 8 . Loukas   M   ,   Klaassen   Z ,   Tubbs   RS ,   Derderian   T ,   Paling   D ,   Chow   D ,   Patel   S ,   Anderson   RH .   Anatomical   observations   of   the   moderator   band.   2010     May;23(4):443-50. 9 . 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. 1 0 . 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. 1 1 . 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. 1 2 . SR Mittal . Moderator Band Wrongly Interpreted as RV Mass. JAPI. August 2012;60:1-3. 1 3 . Wong   PC,   Sanders   SP,   Jonas   RA,   Colan   SD,   Parness   IA,   Geva   T,   Van   Praagh   R,   Spevak   PJ.   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. 1 4 . 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. 1 5 . 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. 1 6 . S.T.F.   Bandeira,   G.C.   Wafae,   C.   Ruiz,   S.R.   Nascimento,   J.R.   Fernandes,   N.Wafae.   Morphological   classification   of   the   septomarginal   trabecula   in   humans, Folia Morphol. 2011;70(4):300–304. 1 7 . R. C. Truex, L. J. Warshaw. The incidence and size of the moderator band in man and in mammals. Anat. Rec., 1942;82:361–372. 1 8 . W. Turner     Moderator Band in Left Ventricle and Tricuspid Left Auriculo-Ventricular Valve. J Anat Physiol. 1898 Apr;32(Pt 3):373–376. 1 9 . M.R.M.   Jongbloed ,   M.C.E.F.   Wijffels ,   Development   of   the   Right   Ventricular   Inflow   Tract   and   Moderator   Band.   A   Possible   Morphological   and   Functional Explanation for Mahaim Tachycardia. Circulation Research. March 10, 2005;96:776-783. 2 0 . 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 . 21. Richard A Jonas., Comprehensive Surgical     Management of Congenital Heart Disease.J R Soc Med. 2004 Aug; 97(8): 407–408.