Posterior interventricular artery

In the coronary circulation, the posterior interventricular artery (PIV, PIA, or PIVA), most often called the posterior descending artery (PDA), is an artery running in the posterior interventricular sulcus to the apex of the heart where it meets with the anterior interventricular artery or also known as Left Anterior Descending artery. It supplies the posterior third of the interventricular septum. The remaining anterior two-thirds is supplied by the anterior interventricular artery which is a septal branch of the left anterior descending artery, which is a branch of left coronary artery.

Posterior interventricular artery
Base and diaphragmatic surface of heart. (Posterior descending artery not visible, but it runs near the middle cardiac vein, which is labeled at the bottom.)
RCA = right coronary
AB = atrial branches
SANB = sinuatrial nodal
RMA = right marginal
LCA = left coronary
CB = circumflex branch
LAD/AIB = anterior interventricular
LMA = left marginal
PIA/PDA = posterior descending
AVN = atrioventricular nodal

SCV = small cardiac
ACV = anterior cardiac
AIV/GCV = great cardiac
MCV = middle cardiac
CS = coronary sinus
Sourceright coronary artery
Veinmiddle cardiac vein, posterior interventricular vein[1]
interventricular septum
Latinramus interventricularis posterior arteriae coronariae dextrae
Anatomical terminology

It is typically a branch of the right coronary artery (70%, known as right dominance). Alternately, the PIV can be a branch of the circumflex coronary artery (10%, known as left dominance) which itself is a branch of the left coronary artery. It can also be supplied by an anastomosis of the left and right coronary artery (20%, known as co-dominance).[2]

Variants have been reported.[3]

The anatomical position of the artery is not really posterior, but inferior. The terminology posterior is based on viewing the heart from the "Valentine" position, not by the heart's actual position in the body.[4]

Additional images

Coronary arteries (labeled in red text) and other major landmarks (in blue text). Posterior descending artery is labeled at left.


  1. Nerantzis CE, Lefkidis CA, Smirnoff TB, Agapitos EB, Davaris PS (November 1998). "Variations in the origin and course of the posterior interventricular artery in relation to the crux cordis and the posterior interventricular vein: an anatomical study". Anat. Rec. 252 (3): 413–7. doi:10.1002/(SICI)1097-0185(199811)252:3<413::AID-AR9>3.0.CO;2-9. PMID 9811219.
  2. Fuster, V; Alexander RW; O'Rourke RA (2001). Hurst's The Heart (10th ed.). McGraw-Hill. p. 53. ISBN 0-07-135694-0.
  3. Topaz O, Holdaway B, Bailey NT, Vetrovec GW (1997). "Anatomic variant of the posterior interventricular coronary artery: implications for coronary angioplasty in acute myocardial infarction". Clin Anat. 10 (5): 303–6. doi:10.1002/(SICI)1098-2353(1997)10:5<303::AID-CA2>3.0.CO;2-R. PMID 9283726.
  4. Anderson, Robert H. "Cardiac anatomy revisited". Journal of Anatomy. 205: 159–177. doi:10.1111/j.0021-8782.2004.00330.x. PMC 1571338.

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