Ventricular aberrant bands and hypertrophic trabeculations. A clinical pathological correlation.

We reviewed the clinical, hemodynamic, and pathology data of 22 patients with dilated congestive cardiomyopathy and 13 patients with ischemic heart disease who underwent heart transplantation, primarily to improve the pathological definition of left ventricular (LV) and right ventricular (RV) aberrant bands and hypertrophic trabeculations. Overall prevalence of aberrant bands was 37% in th LV and 28% in the RV. Similar values for hypertrophic trabeculations were 43% and 28%, respectively. Compared with ischemic heart disease, our patients with dilated congestive cardiomyopathy had similar ventricular size and wall thickness, but had a higher prevalence of LV aberrant bands (p = .005) and LV hypertrophic trabeculations (p = .01). Aberrant bands were associated, both in the LV and RV, with dilated cavities (p less than .05), whereas hypertrophic trabeculations were associated with more ventricular hypertrophy and smaller LV size. Following morphological and histological analysis of the aberrant bands, we propose their division into two categories: genuine or primary bands (probably congenital in origin) and secondary bands, which most probably represent trabecular structures that develop a free cavitary course following pathological changes in the ventricular wall structure and cavitary geometry. Compared with the muscular RV bands situated mostly in the distal portion of the ventricle, LV bands were usually fibrotic and had at least one point of insertion in the inflow or outflow tract. The pattern of trabecular hypertrophy was also different in the two ventricles. Ventricular arrhythmias and thrombi occurred equally in patients with and without bands or trabeculations.