Interventricular GrooveEdit

The interventricular groove refers to the longitudinal grooves on the surface of the heart that separate the right and left ventricles. On the anterior surface, this is called the anterior interventricular sulcus, while on the posterior surface it is the posterior interventricular sulcus. These grooves are more than just surface marks; they serve as key landmarks for the heart’s coronary vessels and for surgeons performing procedures involving the ventricles. The grooves run from near the base of the heart toward the apex and help delineate the boundary between the ventricular chambers in both anatomy and imaging.

In the human heart, the grooves host important arteries and veins that supply and drain the ventricular myocardium. The anterior interventricular sulcus contains the left anterior descending artery (LAD), commonly referred to as a major supplier of the anterior wall and interventricular septum, along with accompanying veins such as the great cardiac vein. The posterior interventricular sulcus contains the posterior interventricular artery (often called the posterior descending artery, PDA) in many individuals, along with corresponding venous structures. As such, these grooves are routinely used as palpable and visual landmarks during surgeries such as coronary artery bypass grafting and during catheter-based interventions. The precise pattern of vascular supply in these sulci relates to the broader patterns of coronary circulation and dominance discussed in the linked articles on coronary circulation and dominance in coronary circulation.

Anatomy and morphology

Location and boundaries: The anterior interventricular sulcus is found on the front surface of the heart between the two ventricles, while the posterior interventricular sulcus is on the back and also marks the boundary between ventricles. They contribute to the overall segmentation of the heart’s surface anatomy.
Contents: The anterior sulcus typically houses the left anterior descending artery (LAD) and the great cardiac vein, among smaller vessels. The posterior sulcus commonly contains the posterior descending artery and the middle cardiac vein. The relationships of these vessels to the ventricles are fundamental to understanding myocardial perfusion.
Surface relationships: The sulci intersect with the coronary sulci that separate the atria from the ventricles, and they align with the planes that clinicians use to orient imaging studies and surgical approaches.
Variants: While the general arrangement is consistent, individual hearts show anatomical variation in the depth of the grooves and the exact course of the vessels within them. These variations can influence susceptibility to certain lesions and the planning of interventions.

Development

The interventricular grooves reflect the embryologic formation and remodeling of the heart as it coils and loops to form the four-chamber structure. During development, the myocardium thickens and the ventricular walls come to encase the coronary vessels in predictable corridors. The grooves emerge as surface markers that parallel the internal separation of the ventricles, and their contents differentiate as coronary arteries and veins establish their mature courses. Understanding this development helps explain why the grooves are reliable landmarks across imaging modalities and during surgical exposure.

Function and clinical significance

Landmark utility: The grooves provide reliable exterior landmarks for locating major vessels during procedures such as coronary artery bypass grafting and valve or ventricular surgeries. In imaging studies, the grooves help radiologists orient findings to the correct ventricular wall and interventricular septum.
Vascular supply: Although the grooves themselves are structural features, they closely accompany vessels that perfuse the ventricles. The LAD in the anterior sulcus and the PDA in the posterior sulcus are central to blood supply to large portions of the ventricles, and blockages in these arteries can produce significant myocardial injury. See left anterior descending artery and posterior descending artery for more on those vessels.
Pathology and clinical correlations: Occlusion or stenosis within the vessels contained in these sulci can lead to characteristic patterns of myocardial infarction, with infarcts often localizing to the corresponding ventricular walls. Knowledge of the sulcal anatomy supports targeted diagnostic and therapeutic strategies.

Imaging and diagnosis

Modalities: Cross-sectional imaging such as computed tomography angiography and magnetic resonance imaging can render the interventricular grooves and the vessels within them. Echocardiography may also infer the orientation of the sulci by visualizing ventricular borders and wall motion.
Surgical planning: Preoperative imaging that clearly depicts the anterior and posterior interventricular sulci assists surgeons in planning access routes for grafts or repairs, as well as in avoiding injury to the vessels that traverse the grooves.

Variants and anomalies

Depth and visibility: The depth of the grooves can vary among individuals, affecting how easily vessels in the sulci can be accessed during procedures.
Vascular variations: The origin and course of the PDA and LAD can show variation, with implications for coronary dominance and the distribution of perfusion. These variations are discussed in the broader context of coronary circulation and dominance in coronary circulation.

Terminology and history

Descriptive naming: The terms anterior interventricular sulcus and posterior interventricular sulcus are descriptive and widely used in modern anatomy. Historically, some texts and clinicians also used alternative spellings or Latin terminology, but the descriptive terms remain standard across contemporary reference works.
Eponyms and nomenclature debates: In medical terminology, there is ongoing discussion about the balance between descriptive terms and eponyms. Proponents of descriptive terms argue that they reduce ambiguity across languages and specialties, while supporters of eponyms emphasize historical tradition and the honoring of clinicians. In the context of these sulci, the descriptive wording is generally preferred for clarity in anatomical description and clinical communication. See also discussions in anatomical terminology and related debates within medical nomenclature.