Developmental, normal, and abnormal anatomy of the coronary sinus

Area of Science:

• Embryology
• Cardiovascular Anatomy
• Congenital Heart Disease

Background:

• The coronary sinus develops from the left horn of the embryonic systemic venous sinus.
• It forms during the fifth week of human development and drains the majority of the heart's venous return postnatally.
• Its anatomical boundaries and relationships with cardiac veins are crucial for understanding cardiac venous drainage.

Purpose of the Study:

• To describe the embryological development and postnatal anatomy of the coronary sinus.
• To elucidate the anatomical basis of congenital anomalies involving the coronary sinus and persistent left superior caval vein.
• To provide a comprehensive overview of coronary sinus malformations and their clinical implications.

Main Methods:

• Review of embryological development of the systemic venous sinus.
• Anatomical description of the coronary sinus and its tributaries.
• Discussion of pathological conditions and malformations of the coronary sinus.

Main Results:

• The coronary sinus originates from the left horn of the systemic venous sinus and incorporates into the atrioventricular groove.
• It forms the great, middle, and small cardiac veins and drains most of the heart's venous return.
• Congenital anomalies include persistence of the left superior caval vein, imperforate Thebesian valve causing atresia, sinus unroofing, and aneurysmal dilation.

Conclusions:

• The coronary sinus is a vital structure with a complex embryological origin.
• Understanding its development is key to recognizing and managing congenital cardiac anomalies.
• Malformations of the coronary sinus can significantly impact cardiac venous drainage and function.