What should we call the 'crista'?

Abstract

Review ofpublished work concerning congenital cardiac anomalies reveals that at leastfour different structures have been described as the crista supraventricularis, in addition to the structure which in the normally formed right ventricle separates pulmonary and tricuspid valves. Possibility offurther confusion arises since at least two different structures have been described under the name 'septal band'. We suggest that this potentially confusing situation will be best resolved by reserving the term 'crista'for description of the muscle mass between inflow and outflow portions of the right ventricle when there are no additional outflow tract anomalies. We then suggest that at least three separate structures warrant description in hearts with outflow tract anomalies. The first separates the semilunar valves, the second separates a semilunar valve from an atrioventricular valve, and the third is an extensive septal trabeculation of the right ventricle. Our suggested terms for these structures are the infundibular septum, ventriculo-infundibular fold, and trabecula septomarginalis, respectively. However, we believe that such terms would be better decided and agreed upon within an internationally formulated 'Nomina Cardiologica', a terminology as yet lacking in congenital heart disease.Many of the controversies in paediatric cardiology relate not so much to differing observations as to differing interpretations of the embryological derivation of structures, and hence to usage of different names to describe these structures.

Divided right ventricle: A review of its anatomical varieties

“…In its roof is a muscular structure which separates the atrioventricular and arterial valves; these components are generally termed the "crista supraventricularis." It can be shown by dissection that the crista itself is composed of a parietal portion, the ventriculoinfundibular fold [2], which separates the tricuspid and the pulmonary valves, and a septal portion, the outlet or infundibular septum [2], which separates the pulmonary and the aortic outlets. The greater part of the crista is simply the infolded heart wall and this, together with its septal component, forms a part of the walls of the ventricular outlet component or infundibulum.…”

“…The septal component is intimately related to a third prominent muscular structure called "trahecula septomarginalis" [2]. This is an extensive septal trabecula composed of a "body" plastered on the septal surface, and anterior and posterior cranial "limbs" which embrace the infundibular or outlet septal component of the crista.…”

Morphological Characterization of Ventricular Septal Defect with Posterior Deviation of the Outlet Septum

“…The following structures are defined: The right ventriculoinfundibular fold (RVIF) is the muscle bar that separates the tricuspid valve from the pulmonary valve of the right ventricle [10]. It is formed by the infolding of the heart wall and is part of the free-standing pulmonary infundibulum.…”

Revisiting the Anatomy of the Living Heart

“…45 The basal part of the triangle (Figure 5, Left panel) is formed by the membranous part of the septum (Figure 6), itself crossed by the hinge of the septal leaflet of the tricuspid valve to separate it into atrioventricular and interventricular components (Figure 4, Left panel). The apex of the interleaflet triangle, however, is extracardiac (Figure 8, Left panel).…”