Posterior descending artery

The posterior descending artery, also called the posterior interventricular artery, follows the posterior interventricular sulcus toward the apex of the heart. Its branches contribute to posterior ventricular and septal supply.^[ref]

Its parent route is central to coronary dominance. In a right-dominant pattern it arises from the right coronary artery; a left-dominant route involves the circumflex artery. The branch's descriptive name identifies a course, while its origin identifies a connection within the coronary network.

Tracing the two possible routes makes the distinction concrete. One goes from the aorta into the right coronary artery and then to this branch. The other passes from the aorta into the left coronary artery, then the circumflex artery, before reaching it. The same distal branch name can therefore sit downstream of different proximal segments.

Primary direct and X-ray observations of injected hearts demonstrate that branching varies even within a dominance class.^[ref] A textbook route is a reference for identifying the observed anatomy, rather than a reason to overwrite a different observed connection.

The vessel should also be distinguished from the neighboring venous route. The middle cardiac vein follows the posterior interventricular region toward the coronary sinus. Arterial delivery and venous collection describe different directions and different sampled blood pools, even when the structures lie close together.