ANATOMICAL BASIS FOR THE SEPARATION OF 4 CARDIAC ZONES IN THE WALLS OF HUMAN HEART VENTRICLES

The coronary vessels of 70 human hearts were visualized postmortem by injection of the coronary arteries with a X-ray opaque substance (for angiographic studies) or with a low viscosity resin (to obtain vascula r casts). Analysis of the data suggests a new anatomical systematizati on of the vascularization of the myocardial tissue of human heart vent ricles: it can be divided into four zones each having a different orig in of the arterial vessels. These four components of the heart ventric les are the antero-septal (AS), postero-septal (PS), left-lateral (LL) , and right-lateral (RL) zones. They correspond to the territories of the anterior interventricular branch of the left coronary artery (AS z one), of the posterior interventricular branch of the right coronary a rtery (PS zone), of the left circumflex artery (LL zone), and of the r ight coronary artery (RL zone) up to the origin of the posterior inter ventricular artery. This systematization of the arterial heart ventric les in zones offers a balanced division of the myocardial tissue, sinc e each of the four zones occupied about one fourth of the total volume of the ventricles. In our samples, the most common distributin of seg ments in the wall of heart ventricles was the following: 16 segments i n the AS zone, 11 segments in the PS zone, 5 segments in the LL zone, and 4 segments in the RL zone. The separation of four zones in the wal ls of heart ventricles, each of them made up of different segments, ma y be helpful in the understanding of the pathophysiology of myocardial ischemia, and also in the choice of surgical strategies to treat aneu risms of the heart ventricle wall.