Abstract
Muscular inclusion at the base of the right coronary sinus in aortic valves has previously been described by our group. It occurs due to crossing of the ventriculoaortic junction above the level of the virtual basal ring and aortic cusp insertion.1 This anatomic entity, however, has not been previously described in pulmonary valves. Herein, we are demonstrating that muscular inclusion at the base of the pulmonary valve sinus can also occur (Figure 1; blue arrows depict anterior pulmonary valve cusp; black arrows depict muscular inclusion of the anterior pulmonary valve sinus), but it is a subtle finding, and can hence be easily overlooked.
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