Middle hepatic artery

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The middle hepatic artery (MHA) is an intrahepatic hilar arterial branch, usually arising from the left hepatic artery, which supplies segments 4a and 4b. It runs towards the right side of the umbilical fissure.

Variant anatomy

  • it may arise from the right hepatic artery 
  • it may arise as a trifurcation of the proper hepatic artery (PHA) in the porta hepatis along with the left and right hepatic arteries
  • in patients with a replaced left hepatic artery, the MHA arises from the right hepatic artery
  • in patients with a replaced right hepatic artery, the MHA arises from the left hepatic artery
  • if the bifurcation of the PHA is low within the porta hepatis, then the MHA may have an extrahepatic course and traverse Calot triangle placing it at risk during cholecystectomy
  • it may give rise to a falciform artery