GROSS MORPHOLOGY AND ARTERIAL SUPPLY OF PAPILLARY MUSCLES OF LEFT VENTRICLE OF MAN

The arterial vasculature of the papillary muscles of the left ventricle was studied in detail in ten human hearts, using the technique of stereoscopic arteriography followed by detailed histologic examination. The arrangement of the arterial vasculature of the papillary muscle seemed to be related to the gross morphologic characteristics of the papillary muscle. Two predominant types of arrangement were noted. Papillary muscles that were fingerlike received a large central artery which coursed through the entire papillary muscle to its apex dividing dichotomously to supply the papillary muscle. Such papillary muscles had very few or no anastomotic connections with the extrapapillary subendocardial plexus of vessels. The papillary muscles that were completely tethered to the subjacent ventricular wall had a segmental distribution of the long penetrating intramyocardial vessels. The papillary muscles of the mixed type had a combination of both types of vascular arrangement. Both the mixed type and the completely tethered papillary muscles with the segmental pattern of arterial distribution had many anastomotic connections with the extrapapillary subendocardial plexus. These anatomic variations could have a considerable influence on functional alterations as well as pathologic changes in the papillary muscles accompanying disturbances in arterial circulation to the region of the papillary muscles. © 1969.