The biggest challenge in drawing the LVS base is depicting the proper septal perforator. Many septal perforators can be found in the left anterior descending artery (from one to three on the first 25 mm distance). The first anterior septal branch is usually the most prominent (40–60 mm in length) and provides the most important collateral channels. However, only 30% of normal angiograms demonstrate a large (1.5 mm in diameter or larger) first septal perforator that distally arborizes into at least four branches. In 28% of cases, the first perforator is a small artery, with a further 24% of patients having two or three arteries comparable in size. Finally, in the last 18% of the hearts, the septal perforator diffuses into multiple small septal arteries [31] (Figure 3A,B). When only one septal perforator is present in the proximal aspect of the left anterior descending artery, the definition of the LVS is indisputable, whereas when there are more perforators, the LVS definition should take the perforator with the largest diameter (Figure 4A). There is another reason for choosing the most dominant perforator that relates to available imaging methods. In cardiac computed tomography angiography, the septal perforator imaging can usually visualize a vessel larger than 1 mm in diameter. Smaller vessels visible in the macroscopic dissection might be unnoticed in clinical assessment.