Anatomical Basis for the Coronary Venous Outflow

Ratajczyk-Pakalska, E; Kolff, Willem J.

doi:10.1007/978-3-642-54127-8_6

Cited by 15 publications

(7 citation statements)

References 4 publications

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“…T h e walls of the right auricle are drained mostly by real Thebesian vessels, which were revealed not by dissection but by casting techniques. Studies by Bohning et al (1933), Unger (1938), Ratajczyk-Pakalska and Kolff (1984), and James et al (1982) revealed a similar location and distribution of these vessels. Because of the contribution of small arterioles, the SCVS is better named the small cardiac vascular system.…”

Section: Venoluminal Vessels Which Connect Intramuralmentioning

confidence: 71%

“…T h e walls of the right auricle were mostly drained by real Thebesian vessels, that were not visualized by dissection but by casting techniques. Studies by Bohning et al (1933), Unger (1938), Ratajczyk-Pakalska and Kolff (1984), and James et al (1982) demonstrate a similar location and distribution of these vessels. Although Bochdalek (1868), Langer (1880), and others, even nowadays, stated, like Thebesius himself, that all atrial vessels belong to the Thebesian vessels, we have presented evidence that Fig.…”

Section: Right Atriummentioning

confidence: 76%

“…4. Arteroluminal vessels connecting small arteries or arterioles with atria or ventricles (Grant and Viko, 1929;Prinzmetal et al, 1947;Blake et al, 1964;Baroldi and Scomazzoni, 196.5;Gould, 19.53;Lindenau and Romaniuk, 1983;Heintzberger, 1984;Ratajczyk-Pakalska and Kolff, 1984;Moscovici, 1985).…”

Section: Venoluminal Vessels Which Connect Intramuralmentioning

confidence: 99%

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Atrial veins of the human heart

et al. 1995

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Modern anatomical description divides the cardiac veins into two groups: tributaries of the greater cardiac vascular system (GCVS) and tributaries of the smaller cardiac vascular system (SCVS), consisting of the Thebesian vessels. Both systems intercommunicate extensively. With the exception of the oblique vein of the left atrium (Marshall's vein), veins draining the walls of both the left and right atrium have not been well illustrated or described in anatomical atlases and textbooks. Consequently, we do not know exactly to which of the two groups (GCVS or SCVS) the atrial veins belong. There are three groups of left atrial veins: (1) tributaries of the left coronary vein and the coronary sinus; (2) special veins draining the right-sided walls of the left atrium that terminate via intramural sinuses in the right atrium, which vessels occur in 92% of cases and belong to the GCVS; (3) in 81% of cases special veins drain the myocardium of the posterior and superior walls of the left atrium. In most cases they empty into the left atrium itself; in almost 40% of the cases they are connected with mediastinal veins. These veins, also belonging to tributaries of the GCVS, constitute a distinctly separate category of cardiac veins and should be designated proper veins of the left atrium. The veins draining the walls of the right atrium fall also into three groups: (1) In most cases there are short or large intramural tunnels or sinuses in the basic walls of the auricle and atrioventricular node area. The generally valveless openings of all the venous tunnels and sinuses are lined up on a circle just above the tricuspid valve and between the openings of both venae cavae. (2) There are also thin veins at the junction of the right atrium with both the superior and inferior vena cava. (3) In addition, there are numerous cardiac veins of the "smallest size" (real Thebesian veins).

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Section: Venoluminal Vessels Which Connect Intramuralmentioning

confidence: 71%

Section: Right Atriummentioning

confidence: 76%

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Atrial veins of the human heart

et al. 1995

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“…r ϭ Ϫ0.59, y ϭ 49.60 Ϫ 3.11x, P Ͻ 0.01, n ϭ 19. One major factor that determines the degree to which CSP is increased by CSO is a route other than the coronary sinus that can drain coronary venous blood, such as Thebesian veins that connect directly with the chambers of the heart, the anterior cardiac veins that connect with the right atrium independently of the coronary sinus (19,24), and the small coronary vein branches that connect with the right atrium distal to the site of the CSO balloon. If these extra routes are well developed, increasing the CSP becomes difficult.…”

Section: Discussionmentioning

confidence: 99%

Coronary sinus occlusion enhances coronary collateral flow and reduces subendocardial ischemia

Ido

Hasebe

Matsuhashi

et al. 2001

American Journal of Physiology-Heart and Circulatory Physiology

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On the hypothesis that coronary sinus occlusion (CSO) may reduce myocardial ischemia, we examined the effects of CSO on coronary collateral blood flow and on the distribution of regional myocardial blood flow (RMBF) in dogs. Thirty-eight anesthetized dogs underwent occlusion of the left anterior descending coronary artery with or without CSO and intact vasomotor tone. We measured RMBF and intramyocardial pressure (IMP) in the subendocardium (Endo) and subepicardium (Epi) separately. With intact vasomotor tone, CSO during ischemia significantly increased RMBF in the ischemic region (IR), particularly in Endo from 0.17 +/- 0.03 to 0.33 +/- 0.05 ml x min(-1) x g(-1) (P < 0.05), and increased the Endo/Epi from 0.59 +/- 0.10 to 1.15 +/- 0.15 (P < 0.01). These effects of CSO were partially abolished by adenosine. However, the Endo/Epi was still increased from 0.90 +/- 0.13 to 2.09 +/- 0.30 (P < 0.01). The changes in RMBF in IR were significantly correlated with the peak CS pressure during CSO. The Endo/Epi of IMP in IR was significantly decreased during CSO. In conclusion, CSO potentially enhances coronary collateral flow, and preserves the ischemic myocardium, especially in Endo.

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“…The dominant system provides 60% to 85% of myocardial drainage and empties the arterioles into the capillaries then into the cardiac venous system to the middle great cardiac vein, and finally into the coronary sinus and right atrium (I ,9, 14-17). The lesser drainage system provides the remainder of myocardial drainage allowing coronary artery blood to flow into the deep myocardial venous circulation which then drains directly into the cardiac chambers (14)(15)(16)(17). Thebesian veins and arteriosinusoids are two of the principal structures of the lesser drainage system.…”

Section: Discussionmentioning

confidence: 99%

Antegrade versus Retrograde Cardioplegia for Uncomplicated Coronary Artery Disease: A Comparative Study

Hunt,

Stammers,

Robinson

1995

J Extra Corpor Technol

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Since the introduction of the retrograde administration of cardioplegic solutions in cardiac surgery in the mid-1980's, the technique has been widely adopted for routine use in high risk patients with impaired ventricular function, based on favorable results demonstrated in clinical series. However, we sought to evaluate the benefits of routine use of this method in low risk patients by means of a retrospective review of 34 consecutive non-repeat, isolated coronary artery bypass grafting patients with left ventricular ejection fractions > 35%. Seventeen patients received intermittent ante grade cardioplegia exclusively and 17 received ante grade induction followed by intermittent retrograde cardioplegia maintenance. No significant baseline differences were found between the two groups. There were no deaths or major complications in either group. Retrograde cardioplegia patients had significantly lower pulmonary artery diastolic pressures in the first 24 hours postoperatively, accompanied by a non-significant trend toward higher cardiac indices during this same period. Phenylephrine infusions were used more frequently during the postoperative period in the retrograde group (p = 0.021). Fewer pulmonary complications were seen in the retrograde cardioplegia group (p=0.042), in addition to non-significant trends toward less atrial arrhythmias and less hospital days. No adverse effects or increased operative time could be attributed to the retrograde administration of cardioplegic solution in this study population. Based on the results from this small clinical series, retrograde cardioplegia administration offers distinct advantages for myocardial protection in low risk coronary bypass patients, as manifested by improved postoperative hemodynamic performance, with no significant adverse effects. A prospective, randomized trial of this technique in a larger, similar patient population is likely to show even more compelling positive results favoring the routine use of retrograde administration of cardioplegic solutions.

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Anatomical Basis for the Coronary Venous Outflow

Cited by 15 publications

References 4 publications

Atrial veins of the human heart

Atrial veins of the human heart

Coronary sinus occlusion enhances coronary collateral flow and reduces subendocardial ischemia

Antegrade versus Retrograde Cardioplegia for Uncomplicated Coronary Artery Disease: A Comparative Study

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