Great cardiac vein
Citation, DOI, disclosures and article data
At the time the article was created Matt A. Morgan had no recorded disclosures.
View Matt A. Morgan's current disclosuresAt the time the article was last revised Bálint Botz had no recorded disclosures.
View Bálint Botz's current disclosures- GCV
- left coronary vein
The great cardiac vein (GCV) runs in the anterior interventricular groove and drains the anterior aspect of the heart where it is the venous complement of the left anterior descending artery. It is the main tributary of the coronary sinus.
Gross anatomy
It begins on the anterior surface of the heart near the apex where small tributaries of the great cardiac vein anastomose with tributaries of the middle cardiac vein. It ascends in the anterior interventricular groove with the left anterior descending artery.
At the coronary sulcus it turns left, to runs alongside the circumflex artery in the left atrioventricular groove. Blood in each vessel flows in the same direction at this site. The great cardiac vein then drains into the left end (origin) of the coronary sinus, at the same end as the oblique vein of Marshall which together marks the origin of the coronary sinus.
Relations
The relationship of the great cardiac vein to the left anterior descending artery is highly variable. In 60-70% of cases, the vein is superficial to the artery.
Drainage
The vein drains the:
- anterior surface of the right and left ventricles (up to and including the apex)
- anterior interventricular septum
- portions of the left atrium
Variant anatomy
- the vein may drain directly into the right atrium or azygos vein
- there may be aneurysmal dilatation of the great cardiac vein
- occurs in ~1.5% of cardiac CT studies, second most common coronary vein aneurysm
Knowledge of variants may be useful for preoperative planning.
References
- 1. Saremi F, Muresian H, Sánchez-Quintana D. Coronary veins: comprehensive CT-anatomic classification and review of variants and clinical implications. Radiographics. 2012;32 (1): E1-32. doi:10.1148/rg.321115014 - Pubmed citation
- 2. Moore KL, Agur AMR, Dalley AF. Clinically oriented anatomy. LWW. ISBN:1451119453. Read it at Google Books - Find it at Amazon
- 3. Last's anatomy, regional and applied. Churchill Livingstone. ISBN:044304662X. Read it at Google Books - Find it at Amazon
- 4. Shah SS, Teague SD, Lu JC, Dorfman AL, Kazerooni EA, Agarwal PP. Imaging of the coronary sinus: normal anatomy and congenital abnormalities. (2012) Radiographics : a review publication of the Radiological Society of North America, Inc. 32 (4): 991-1008. doi:10.1148/rg.324105220 - Pubmed
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