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Updated: Jun 7, 2025
Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
An exceptional anomaly of the coronary venous drainage: anatomic description
Manon Hily1,2, Bettina Bessières3, Damien Bonnet1,2
1Congenital and Pediatric Cardiology Unit, M3C-Necker, APHP, Hôpital Necker-Enfants malades, Paris, France.
Insights
This study describes a rare fetal heart anomaly where the coronary sinus is located in the right atrioventricular sulcus, associated with congenitally corrected transposition. This unique coronary sinus anomaly may indicate further developmental pathway disturbances.
Area of Science:
- Cardiovascular Anatomy
- Developmental Biology
- Congenital Heart Disease
Background:
- Coronary sinus anomalies are uncommon but more prevalent in congenital heart defects.
- Typically, the coronary sinus resides in the left atrioventricular sulcus, inferior to the left atrium.
Purpose of the Study:
- To report a unique fetal cardiac specimen with an anomalous coronary sinus.
- To investigate the relationship between this anomaly and congenitally corrected transposition.
Main Methods:
- Detailed morphological examination of a fetal cardiac specimen using segmental analysis.
- Performed by two independent observers for accuracy.
Main Results:
- A novel cardiac specimen exhibited a coronary sinus in the right atrioventricular sulcus, receiving most coronary veins.
- This anomaly was observed in a fetus with congenitally corrected transposition and situs solitus.
- The venous drainage pattern was a mirror image of normal anatomy and distinct from typical congenitally corrected transposition.
Conclusions:
- The unusual coronary sinus location in this case may be linked to an additional disturbance in embryonic laterality.
- This finding highlights the variability of cardiac development in complex congenital heart defects.
Background:
Anomalies of the coronary sinus are rare in the general population but are more frequent in patients with congenital heart defects. Whatever the cardiac anatomy, the coronary sinus is invariably located in the left atrioventricular sulcus, inferior to the wall of the morphologically left atrium.
Methods:
A complete morphological examination of a fetal cardiac specimen of the M3C collection, according to segmental analysis, was performed by two observers.
Results:
We report here for the first time a cardiac specimen with a venous channel receiving the majority of coronary veins, located in the right atrioventricular sulcus and therefore inferior to the wall of the morphologically right atrium, in a fetal cardiac specimen with congenitally corrected transposition in situs solitus. In addition, the anatomy of the venous drainage of the heart was mirror-imaged to that observed in a normal heart and different compared to that usually observed in congenitally corrected transposition.
Conclusion:
This very particular anatomy occurring in association with congenitally corrected transposition might be related with an additional disturbance in the laterality pathway.
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