Keywords:
Embolism / Thrombosis, Screening, CT-Angiography, Cardiovascular system
Authors:
B. Özkul, N. Inan, �. Özkul, H. T. Sarisoy, G. Akansel, A. Akça, �. Çam; Kocaeli/TR
DOI:
10.1594/esti2014/P-0085
Background
Anatomy of cardiac venous system
The venous drainage of the heart consists of two separate systems draining the right and left ventricular arterial flow.
Normally the right ventricle is drained via the anterior cardiac veins running along the anterior right ventricular surface and draining separately into the right atrium; this accounts for approximately 15% of the total cardiac venous return.
The remainder of the cardiac venous return is via the coronary sinus,
a large venous channel running in the left atrio-ventricular sulcus.
Fig. 1
![](https://epos.myesr.org/posterimage/esr/esti2014/125149/media/586494?maxheight=300&maxwidth=300)
Fig. 1: Anatomy of the coronary sinus
References: The McGraw-Hill Companies, Inc.
Tributaries with contribution to the coronary sinus include: the anterior interventricular vein,
also known as the great cardiac vein,
running in the anterior interventricular sulcus parallel to the left anterior descending coronary arterry; the posterior interventricular vein (middle cardiac vein) running in the posterior interventricular sulcus parallel to te posterior descending coronary artery; and the small cardiac vein running in the right atrioventricular sulcus.
Other venous channels entering either the great cardiac vein or directly into the coronary sinus include: the oblique vein of the left atrium (oblique vein of Marshall); the obtuse marginal vein running parallel to the obtuse marginal branch of the left circumflex coronary artery; and the posterior left ventricular veins running parallel to the posterior left ventricular branches of the left and right ventricles.
Fig. 2
![](https://epos.myesr.org/posterimage/esr/esti2014/125149/media/586519?maxheight=300&maxwidth=300)
Fig. 2: Anterior view of heart
References: The McGraw-Hill Companies, Inc.
Although these two venous systems are anatomically distinct with separate entrances into the right atrium,
there are many anastomotic connections between the two allowing diversion of flow from one to the other if resistance in one channel should increase for any reason.