The arterial supply of the interventricular septum of the human heart


ÜZEL M. , von Lüdinghausen M.

21st Annual Meeting of the AACA, Moraga, United States Of America, 8 - 12 June 2004, vol.17, no.7, pp.602

  • Publication Type: Conference Paper / Full Text
  • Volume: 17
  • City: Moraga
  • Country: United States Of America
  • Page Numbers: pp.602

Abstract

This study was designed to determine the pattern of arterial supply of, and arterial preponderance in, the human interventricular septum (IVS). One hundred human heart specimens (84 cadaveric specimens and 16 corrosion casts) were studied macro-anatomically. The coronary arteries were injected barium sulphate and red resin in 20 specimens. In 38 specimens intramural courses of the septal arteries were exposed, eight radiographs of the IVS were made. The IVS was divided into superior and inferior parts; each of which further divided into anterior, middle, and posterior parts; additionally an apical section was determined. Extramural portions of the septal arteries were exposed and then intramural
courses were traced. All septal branches derived from arteries of the coronary and interventricular sulci of the heart. In 15 cases a few or all septal arteries were not visible on the surface of the heart because they were covered by myocardial bridges. In general there was a left dominance of arterial supply of the IVS, because the anterior and apical septal branches of the anterior interventricular artery (AIA) were frequent and strong. The strongest septal branch was the anterior descending septal artery (ADSA) or main septal artery (MSA) (n =72
cases). The mean length of its extra- and intramural stem was 16 mm. Intramurally it bifurcated into superior and inferior branches that supplied the middle superior and middle inferior sections of the IVS. In 15 cases we found instead of an ADSA two or three smaller anterior septal branches of similar strength and length (n  9). A terminal twig of the inferior branch of the ADSA supplied the moderator band and even the anterior papillary muscle; however, there were cases exhibiting accessory branches directly deriving from the AIA or further septal branches (n  4). The left superior septal artery (LSSA) was emerging from
the AIA and supplied the anterior superior section of the IVS; however, it did not always exist. In three cases there was a right dominance of the arterial supply of the IVS. In these cases the right superior septal artery (RSSA) deriving from the stem of the right coronary artery (RCA) was rather strong and supplied the middle superior section of the IVS. In some cases it was longer and reached and supplied even the moderator band and anterior papillary muscle. In five cases there was a balanced type of arterial supply of the IVS. There was a crossing maneuver of terminal branches of the ADSA and RSSA that were of equal size. The posterior
septal arteries derived from the posterior interventricular artery (PIA) and supplied the posterior superior and posterior inferior sections of the IVS. In a few cases some posterior septal branches derived from the right marginal artery. The apical section was supplied by apical branches from the AIA. In 92 cases there was a left coronary dominance of the IVS because the ADSA and further anterior septal arteries were the main supplier; in five cases there was a balanced type of IVS supply because both ADSA and RSSA were equal in size and length; in three cases there was a right coronary dominance of the IVS because the RSSA was the
main supplier of the IVS.