The Left Side Anterior
LAD Coursing in the Interventricular Groove
15009c
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Branches
3-5 Diagonals supplying the anterior portion of the LV
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OBTUSE MARGINALS OFF THE CIRCUMFLEX (3-4 vessels)
supplying the lateral and posterior portion of the LV
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INFUNDIBULAR BRANCH SUPPLYING THE ARC OF VIEUSSENS
Important collateral from proximal LAD to proximal RCA
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CIRCUMFLEX AND OBTUSE MARGINALS
in lateral projection supplying the lateral and posterior portions of the LV
Circumflex
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OBTUSE MARGINALS OFF THE CIRCUMFLEX POSTERIOR VIEW in a right dominant system. In this case only about 50% of the inferior portion of the LV is supplied by the LCA
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RIGHT SIDE ? DOMINANT
MAIN RCA IN ANTERIOR A-V GROOVE
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INFUNDIBULAR BRANCH SUPPLYING THE ARC OF VIEUSSENS
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RIGHT SIDE POSTERIOR VIEW ? CONTINUATION OF THE RCA
CONTINUATION OF THE RCA
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PDA
Note it runs side by side with the middle cardiac vein
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POSTERIOR LV BRANCHES
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A-V NODAL ARTERY
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The anatomical specimen has been injected with barium and shows the circumflex (c) arising from the left main coronary artery. The obtuse marginal arteries are large vessels so the distal circumflex continuation (c c green arrow) is a small vessel that runs in the posterior A-V groove with the coronary sinus
The S-A nodal artery (s-a) sometimes arises from the circumflex as the first branch. Atrial branches (a) also arise from the proximal circumflex artery.
A number of obtuse marginal arteries (OM1 and OM2 ) supply the posterior and posterolateral parts of the LV and are almost always larger than the distal circumflex itself (c c).
Ashley Davidoff MD