Related Experiment Videos
Clinical anatomy of cardiac veins, Vv. cardiacae
1Anatomisches Institut, Universität Würzburg, BRD.
Insights
Detailed anatomical knowledge of cardiac veins is crucial for new cardiac interventions. This study reveals variations in cardiac vein systems and intramural structures that can complicate procedures like catheterization.
Area of Science:
- Anatomy
- Cardiology
- Medical Imaging
Background:
- Advancements in cardiac interventions necessitate precise understanding of cardiac venous anatomy.
- Variations in cardiac vein drainage can impact procedural success and patient outcomes.
Purpose of the Study:
- To provide an exact account of the distribution and opening patterns of cardiac veins.
- To identify anatomical variations that may pose challenges for cardiac catheterization and venous reperfusion.
Main Methods:
- Macroscopical examination of 350 prepared human hearts.
- Analysis of three major cardiac vein systems: coronary sinus tributaries, anterior cardiac veins, and atrial cardiac veins.
Main Results:
- Identified three main cardiac vein systems with variable tributaries.
- Observed intramural collecting chambers (sinuses) before vein openings, potentially aiding venous return.
- Documented significant variability in the small cardiac vein and right marginal vein pathways, altering the functional importance of the coronary sinus system.
- Described intramural courses, ostial valves, and other structures that can impede catheterization and reperfusion.
Conclusions:
- Anatomical variations in cardiac veins, including intramural sinuses and variable tributary patterns, are common.
- These variations can create morphological challenges for cardiac catheterization and venous reperfusion procedures.
- A comprehensive understanding of cardiac venous anatomy is essential for developing and refining interventional cardiology techniques.
Abstract:
New methods of cardiological examination and treatment, such as catheterization and arterialization of the coronary sinus, venous reperfusion and cardioplegia have made necessary an exact account of the distribution pattern and the mode of opening of the cardiac veins. 350 hearts were prepared for examination with macroscopical techniques. There are three systems of the major cardiac veins: tributaries of the coronary sinus, anterior cardiac veins, atrial cardiac veins. Their openings lie in a circle-like arrangement between the ostia of both caval veins and just above the tricuspid valve. In most cases there are variably sized intramural collecting chambers or sinuses just before the opening of all the cardiac veins. These sinuses are interpreted to favour the return of cardiac venous bloodstream from the myocardium to the right atrial cavity. The tributaries of the coronary sinus and of the anterior cardiac veins are very variable. There is for instance only in 36% of cases a small cardiac vein, which belongs to the coronary sinus system. In 64% a small cardiac vein does not exist, but its origin, the right marginal vein, joins the system of anterior cardiac veins. This behaviour diminishes the function of the coronary sinus and increases the importance of the system of anterior cardiac veins. Intramural courses of the great cardiac vein, crossing coronary arteries, ostial valves of cardiac veins, ostial valve of coronary sinus and of inferior vena cava, ostial occlusion of coronary sinus, and aneurysm like excavation of the posterodorsal wall of the right atrium have been described also. These facts and structures may cause morphological hindrances fo catheterization of the right atrium and coronary sinus and for reperfusion of cardiac venous drainage pathways. This report about a large conus vein, which is a great cardiac vein joining anterior cardiac veins and about intramural courses of great cardiac vein as well as semicircular venous sinuses in the wall of the right atrium is the first in the literature.