Anterior interventricular artery

At a glance

English

Anterior interventricular artery

Latin (TA2)

Ramus interventricularis anterior arteriae coronariae sinistrae

System

Heart

Region

Trunk

Side

Single, on the midline

About the anterior interventricular artery

The anterior interventricular artery is one of the two terminal branches of the left coronary artery, the other being the circumflex artery. Clinicians usually call it the left anterior descending artery, or LAD. It starts behind the pulmonary trunk, where the short left main stem divides, and passes forwards and down into the anterior interventricular sulcus, the shallow groove on the sternocostal surface that marks the line of the septum between the right and left ventricles.

From there it descends towards the apex, usually with the great cardiac vein beside it. In most hearts it turns round the apex at the notch of the cardiac apex and climbs a short way up the inferior interventricular groove, where it may meet the end of the posterior (inferior) interventricular artery. Along the way it is often buried for part of its length under a thin bridge of heart muscle, a so-called myocardial bridge.

Two sets of branches leave it. Diagonal branches run obliquely over the front of the left ventricle towards its lateral wall. Septal branches plunge at right angles into the interventricular septum. A small branch to the conus arteriosus may also arise near its start and join a matching twig from the right coronary artery around the outflow of the right ventricle.

Because it feeds the front of the left ventricle, the apex and most of the septum, a blockage near its start puts a large mass of heart muscle at risk, and an infarct here typically involves the anterior wall. The septal branches also carry blood to the bundle branches of the conducting system, so disease in this artery can disturb the heartbeat as well as the pump.

Function and supply

Begins at

The left coronary artery, at its division behind the pulmonary trunk, as the branch that continues forwards.

Ends at

Ends at or just beyond the apex, often curving into the lower part of the inferior interventricular groove; gives diagonal, septal and conus branches on the way.

Function

Supplies the anterior wall of the left ventricle, the apex, the front of the right ventricle next to the groove, and the anterior two-thirds of the interventricular septum, including the bundle branches.