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Updated: Aug 18, 2026

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
A review of the coronary venous system: a road less travelled
Siew Yen Ho1, Damián Sánchez-Quintana, Anton E Becker
1Department of Paediatrics, National Heart & Lung Institute, Imperial College and Royal Brompton Hospital, London, UK. yen.ho@imperial.ac.uk
Insights
The coronary venous system, though less studied, is vital for cardiac interventions. Understanding its complex anatomy is crucial for effective percutaneous transcatheter treatments in arrhythmias and heart failure.
Area of Science:
- Cardiovascular Anatomy
- Interventional Cardiology
Background:
- The coronary venous system receives less attention than the arterial system.
- Therapeutic strategies for arrhythmias and heart failure increasingly utilize the coronary venous system.
Purpose of the Study:
- To review the arrangement of main cardiac veins.
- To provide a morphologic background for interventionalists.
Main Methods:
- Review of existing literature on coronary venous anatomy.
- Morphologic analysis of cardiac veins.
Main Results:
- The coronary venous system serves as a conduit for percutaneous transcatheter treatments.
- Significant variability exists in venous valves, diameter, angulation, muscular sleeves, and spatial relationships with coronary arteries.
Conclusions:
- Variations in coronary venous anatomy present challenges for interventional procedures.
- Detailed morphologic understanding is essential for successful percutaneous interventions via the coronary venous system.
Abstract:
Compared with the coronary arterial system, less attention has been paid to the coronary venous system. In the current era, there are therapeutic options for arrhythmias and for heart failure that use the coronary venous system to access target areas. We review the arrangement of the main cardiac veins to provide a morphologic background to interventionists. In general, the venous system is a useful conduit for delivery of percutaneous transcatheter treatment. But, variability in terms of valves, diameter, angulation, extent of muscular sleeves, proximity to other cardiac structures, and cross-over spatial relationship with branches of coronary arteries have implications for practitioners seeking to make use of the system.
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