Penther P, Blanc J J, Boschat J, Granatelli D
Arch Mal Coeur Vaiss. 1977 Oct;70(10):1075-9.
In an anatomical study of 187 patients who had died from various heart disorders, the anterior descending artery (ADA) had an intra-mural course in 33 cases (17.65 p. 100). This abnormal course had had no correlation with the sex of the patients, the nature of the disease, length of the trunk of the left coronary artery, and to the relative sizes of the coronary vascular supply on the right and the left. It is associated, to a degree which may reach statistical significance, with certain abnormalities of distrubution of the ADA itself, of other pericardial arteries, and with a particularly short course which means that it does not reach the apex of the heart in more than a third of cases. The anatomical position of the intraparietal segment appears to be remarkably constant, and several anatomical landmarks (the origin of the second anterior septal artery and of the second diagonal artery, both collaterals of the anterior descending artery) may lead one to suspect the presence of an anomaly in the course of the artery when the coronary arteriogram is doubtful. The thickness of the muscular bridge is variable, but is not as a rule great. The most constant anatomical finding is that the anterior descending artery, in its intra-parietal segment, maintains a thin wall, and is never the seat of atheromatous deposits, whatever the age of the patient.
在一项对187例死于各种心脏疾病患者的解剖学研究中，前降支动脉（ADA）在33例（17.65%）中走行于心肌内。这种异常走行与患者性别、疾病性质、左冠状动脉主干长度以及左右冠状动脉供血的相对大小均无关联。它在一定程度上与ADA本身、其他心包动脉的某些分布异常相关，且与特别短的走行相关，这意味着在超过三分之一的病例中它未到达心脏尖部。壁内段的解剖位置似乎非常恒定，当冠状动脉造影结果存疑时，几个解剖标志（前降支动脉的两个分支，即第二前间隔动脉和第二对角动脉的起源）可能会让人怀疑动脉走行存在异常。肌桥的厚度各不相同，但通常不厚。最恒定的解剖学发现是，前降支动脉在其壁内段保持薄壁，无论患者年龄多大，都不会出现动脉粥样硬化沉积物。
