ChoiceHub
Sign in

Septal perforating branches of the LAD

Branch

Branches that dive perpendicularly into the anterior two-thirds of the interventricular septum; the first septal perforator is the largest and carries the supply to the bundle branches.

Traced from the start

  1. Left (posterior) aortic sinus and left main stem
  2. Left anterior descending (anterior interventricular) artery
  3. Septal perforating branches of the LAD

Detail

Supplies
Anterior two-thirds of the septum, right bundle branch, left anterior fascicle, distal His bundle
Procedure
First septal perforator is the target of alcohol septal ablation in obstructive HCM

When it goes wrong

Anterior MI with new right bundle branch block and left anterior fascicular block

High risk of complete heart block below the His with a slow wide-complex escape; needs temporary pacing and carries a poor prognosis

Practise this structure

2 questions in the bank tagged Cardiac Conduction.

A 24-year-old man presents with two hours of palpitations. He is alert, has no chest pain, and his blood pressure is 124/76 mmHg. The radial pulse is regular at…

Foundations · common

A 46-year-old labourer is freed after six hours trapped beneath a collapsed brick wall. Both thighs are tense, swollen and tender, and he cannot move his toes.…

Foundations · middle twist