Fundamentals of cardiac electrophysiology
Ever D. Grech in Practical Interventional Cardiology, 2017
The coronary sinus extends from the inferior right atrial (RA) septum along the inferior mitral annulus. It has a muscular coat in its proximal course and transitions to the great cardiac vein that continues laterally and superiorly that is marked on the endovascular surface by the valve of Vieussen.6 The great cardiac vein lies alongside the left circumflex artery and continues to become the anterior interventricular vein that runs parallel to the left anterior descending coronary artery. Lateral left ventricular (LV) branches join the coronary sinus at various levels and are potential targets for placement of pacing leads for LV epicardial pacing. The middle cardiac vein is a proximal branch of the coronary sinus that runs in the posterior interventricular grove, parallel to the posterior descending coronary artery. Ablation of some posterior septal accessory pathways is possible from within this branch but runs the risk of inadvertent thermal damage to adjacent branches of the right coronary artery.
Autopsy Cardiac Examination
Mary N. Sheppard in Practical Cardiovascular Pathology, 2022
The coronary veins run with the major arteries and return the blood to the coronary sinus (Fig. 1.13). This drains into the posteroinferior right atrium above the tricuspid valve (Fig. 1.14). The veins form wide, thin channels in both the interventricular and the atrioventricular grooves. The great cardiac vein is formed in the anterior interventricular groove. It then runs around the left AV groove and expands to form the body of the coronary sinus when it is joined by the middle cardiac vein from the posterior interventricular groove draining into the coronary sinus (Figs. 1.13 and 1.14). When the Cx artery is small, the larger, wider great vein can sometimes be mistaken for the circumflex coronary artery in the left AV groove (Fig. 1.15). At the crux, the great cardiac vein merges with the middle cardiac vein, which runs up the posterior interventricular groove and the small cardiac vein to form the coronary sinus (Fig. 1.13). This small cardiac vein initially accompanies the acute marginal artery and runs round the right AV groove before terminating in the coronary sinus at the crux. It is important to examine these veins when retrograde cardioplegia is used in cardiac operations to look for complications such as rupture or thrombosis. The coronary sinus and great vein are closely associated with the mitral annulus and are used for access for catheter ablation of abnormal conduction pathways and cardiac pacing with electrophysiological studies.
Thorax
Dave Maudgil, Anthony Watkinson in The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Are the following statements regarding the venous anatomy of the chest true or false? The accessory hemiazygos system drains into the hemiazygos system at T12.The coronary sinus opens into the left atrium.The internal thoracic (mammary) veins drain into the superior aspect of the brachiocephalic veins.The great cardiac vein ascends in the anterior inter-ventricular groove.The bronchial veins drain on the right into the azygos system and on the left into the hemiazygos system.
Pericardial Anatomy, Interventions and Therapeutics: A Contemporary Review
Published in Structural Heart, 2021
Reza Reyaldeen, Nicholas Chan, Saberio Lo Presti, Agostina Fava, Chris Anthony, E. Rene Rodriguez, Carmela D. Tan, Walid Saliba, Paul C Cremer, Allan L. Klein
The epicardial vasculature is an important consideration in any intervention utilizing a pericardial approach, in part related to the significant variability of these vessels and potentially hazardous complications. For example, the great cardiac vein crosses the left circumflex artery at the left ventricular summit, and is most commonly superficial to the artery in up to 61% of the time, but can also run deep in up to 37% of patients.15 This variation is important in ablative procedures where an unexpected artery between the vein and myocardium could be devastating.5 Epicardial fat surrounds coronary vessels, which is advantageous by providing protection, however, may impact procedural success by inhibiting effective ablation.5
Retrograde venography and three-dimensional mapping of a great cardiac vein with separate drainage into the high right atrium in a patient with Wolf-Parkinson-White syndrome
Published in Baylor University Medical Center Proceedings, 2018
Keith Suarez, Javier E. Banchs, Judith P. Lazol, James N. Black
The coronary sinus (CS) drains most of the venous blood from the heart. Many of its anatomical variants have been described, and some of them have implications for procedures like cardiac resynchronization therapy, heart surgery, mapping and ablation of accessory pathways, and ventricular tachycardias. The great cardiac vein (GCV) and middle cardiac vein are tributaries to the CS and have been shown in imaging and autopsy studies to be very consistent morphologically. We present a patient with a GCV that drained separately from the CS into the right atrium that was found incidentally during mapping and ablation of an accessory pathway.
Appropriate use criteria of left atrial appendage closure devices: latest evidences
Published in Expert Review of Medical Devices, 2023
Fabrizio Guarracini, Eleonora Bonvicini, Alberto Preda, Marta Martin, Simone Muraglia, Giulia Casagranda, Marianna Mochen, Alessio Coser, Silvia Quintarelli, Stefano Branzoli, Roberto Bonmassari, Massimiliano Marini, Patrizio Mazzone
Left atrial appendage has a high variability in its size, shape, and spatial relation with the surrounding structures [41]. It derives from the primordial left atrium, emerging from the margin between the anterior and the lateral LA walls with a small orifice, followed by a narrow neck that unfolds with different curvatures in the body of the appendage. It has anatomical relations with vital organs, like the left circumflex artery and the great cardiac vein
Related Knowledge Centers
- Anterior Interventricular Sulcus
- Atrium
- Ventricle
- Heart
- Coronary Sinus
- Oblique Vein of The Left Atrium
- Vieussens Valve of The Coronary Sinus
- Left Marginal Vein