The nearest relation to the LVS apex or septal aspect of the LVS is the left coronary cusp of the aortic valve or right–left interleaflet triangle [7,17,82] (Figure 4). The septal margin approach is possible to perform from the left coronary cusp of the pulmonary valve and pulmonary trunk in the superior aspect and from the right ventricular outflow tract in the inferior aspect of allied anatomical conditions [SP2] (Figure 4). The septal perforators may also reach the LVS myocardium near the septal margin. The mitral margin may be accessible from the left atrial appendage or great cardiac vein (Figure 3) [33]. A mid aspect of the LVS can be attainable from the venous system: the great cardiac vein, the anterior interventricular vein, the communicating vein, the conus vein and septal venous perforators, or recently proposed left atrial appendage, which covers nearly 75% of the LVS region [15,33,51] (Figures 3 and 4).