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Descending septal artery: an important artery for collateral coronary circulation

Kintur Sanghvi1, Sarah de Leon Mansson, Tejas Patel

  • 1Deborah Heart & Lung Institute, 200 Trenton Road, Browns Mills, NJ 08015, USA. sanghvik@deborah.org

The Journal of Invasive Cardiology
|February 8, 2013
PubMed

Insights

A rare descending septal artery, also known as Bonapace's branch, provided crucial collateral blood flow to an occluded left anterior descending artery in a patient with coronary artery disease. This finding highlights its significant role in myocardial perfusion.

Area of Science:

  • Cardiology
  • Anatomy

Background:

  • Coronary artery disease (CAD) presents a significant global health burden.
  • Intermittent chest pain and inducible ischemia are common symptoms necessitating diagnostic evaluation.

Observation:

  • A 40-year-old male presented with symptoms suggestive of myocardial ischemia.
  • Cardiac catheterization revealed severe coronary artery disease, including a completely occluded mid-left anterior descending (LAD) artery.
  • A rare descending septal artery (Bonapace's branch) was identified originating from a separate ostium in the right aortic sinus.

Findings:

  • The descending septal artery served as a critical source of collateral circulation to the occluded LAD artery.
  • This anatomical variant, rarely observed in vivo, is more frequently documented in postmortem studies.
  • Literature review supports the functional significance of this artery in collateralization.

Implications:

  • The descending septal artery may play a vital role in perfusing the cardiac conduction system.
  • Understanding this rare vessel's contribution to collateral circulation is crucial for managing complex coronary artery disease.
  • This case underscores the importance of recognizing and evaluating rare coronary anomalies for comprehensive patient care.

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