Anatomy of the supraventricular crest in human hearts

The supraventricular crest is a fleshy trabecula of the right ventricle that has an important function in guiding the blood flow. However, controversy persists regarding its anatomical constitution. In this study, we aimed to investigate its frequency, formation, termination, morphometry, and relationships with the septomarginal trabecula, septal papillary muscle, right atrioventricular ring, and left posterior semilunar valve of the pulmonary trunk valve. Our material consisted of 50 hearts from adult individuals of both sexes that had been preserved in 10% formalin. They were opened along the arterial cone by means of an incision starting at the pulmonary trunk and ending at the right margin. The supraventricular crest was always present. The marginal (right) extremity was formed by two to six muscle bundles that joined together (88%). On the septal (left) side, the single muscle bundle penetrated the interventricular septum directly (88%) or by means of two or three divisions (12%). It could form a septal band (52%) and could pass over the septal papillary muscle (43.5%) or just below it (34.8%). There was a relationship of muscle fibres between these two structures in 64% of cases. Dissection of the septal band demonstrated continuity with the septomarginal trabecula (46%). In 80% of cases, the crest was connected to the right atrioventricular ring and it participated in its outline directly (64%) or by means of muscle expansions (16%). Its muscle fibres bordered the left semilunar valve of the pulmonary valve in 50% of cases. Regarding morphometry, we observed that the length varied little with increasing weight of the heart (22.6%), but the height and width increased markedly with increasing weight of the heart.