Great cardiac vein variations

Bales, Gerald S.

doi:10.1002/ca.10248

Cited by 41 publications

(28 citation statements)

References 24 publications

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“…27 The author presented great cardiac vein variation based on intertwined variation found by a medical student during medical anatomy in one case.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Variants of Coronary Venous System on Cardiac Computed Tomography

Młynarski

Młynarska

Sosnowski

2011

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp he variety of cardiac devices for transvenous implantation has increased in the years, mostly due to evidence of effectiveness of this therapy in chronic heart failure. Special attention is placed on cardiac resynchronization therapy (CRT) or combination of those devices with implanted cardioverter defibrillator. 1-5 During these procedures, the implantation of left ventricle lead is necessary. The only way for transvenous left ventricle lead implantation is coronary sinus (CS) cannulation from the right atrium, and finally implantation of the lead into one of the coronary veins. 6 Effectiveness and success of implantation have been shown to depend mainly on a proper placement of the left ventricle electrode into the coronary target vein. 7, 8 Lateral, posterolateral and anterolateral veins (PLV and ALV) provide optimal hemodynamic benefits. Meanwhile, most operators are faced with the problem of huge anatomical variability of coronary veins. Knowledge of the coronary venous system (CVS) anatomy is an important factor before many electrophysiological procedures, such as CRT or ablations. The CVS was the subject of a few research groups, but most of the research came from post mortem studies. 9,10 In a few studies, a huge anatomical variability of CVS was documented; however, its variants have only rarely been classified. 11 Recent data indicated a potential of the latest generation multislice computed tomography (MSCT) scanners for CVS anatomy visualization; 12,13 however, anatomical variants with emphasis on target veins for CRT have not been examined yet.The purpose of the present study was to evaluate anatomical variants of CVS in MSCT in the context of target veins for CRT. MethodsA total of 199 patients (114 males, 57.3%), aged 56.6±11.5 with suspected coronary artery disease (CAD) were included in the study. A suspicion of CAD was based on clinical symptoms such as chest pain, shortness of breath when exercising or during other vigorous activities and other typical/ atypical symptoms co-existing. Non-specific electrocardiogram (ECG) changes and positive results of exercise testing was also a basis for performing MSCT. Arterial hypertension and hyperlipidemia were the most prevalent CAD risk factors, present in 143 (71.8%) and 94 (47.2%) patients, respec- In a few studies, huge anatomical variability of coronary venous system (CVS) has been documented without analysis of its variants. The aim of the present study was to evaluate anatomical variants of CVS in multislice computed tomography (MSCT).

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“…27 The author presented great cardiac vein variation based on intertwined variation found by a medical student during medical anatomy in one case.…”

Section: Discussionmentioning

confidence: 99%

Anatomical Variants of Coronary Venous System on Cardiac Computed Tomography

Młynarski

Młynarska

Sosnowski

2011

Circ J

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“…The vein has been described as originating to the right (Pejkovic and Bogdanovic, 1992;Bales, 2004) and to the left (Ortale and Marquez, 1998;Gerber et al, 2001;Ortale et al, 2001;von Lüdinghausen, 2003b;Bales, 2004) of the anterior interventricular artery. Regardless of its location at its origin, the anterior interventricular vein must eventually course to the left so as to continue as the great cardiac vein.…”

Section: The Great Cardiac Veinmentioning

confidence: 99%

Cardiac veins: A review of the literature

Loukas

Bilinsky

et al. 2008

Clinical Anatomy

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Cardiac veins have long stood in the shadow of their more extensively studied counterparts, the coronary arteries. The clinical importance of the coronary venous system, nonetheless, should not be underestimated. Intricate and beneficial therapeutic options are increasingly being developed that depend on knowledge of the structure of this venous network. Such interventions have been shown greatly to promote cardiac health, and to enhance the efficacy of cardiac pacing. A comprehensive appreciation of the architecture of the coronary venous system, therefore, is crucial to optimal cardiac care. It is possible to provide an overview of the arrangement of the cardiac veins, with the larger veins draining to the coronary sinus, and thence to the right atrium, but with smaller and minimal veins draining directly to the cavities of the atrial chambers. The venous pathways, nonetheless, are highly variable, making exceptions the commonly accepted rule. As such, unique solutions for imaging, and simple attentiveness to possible venous variations, can greatly enhance clinical outcomes. For example, identifying the diameter, course, and valves of the cardiac veins allows for anticipation of impediments during interventional procedures, and allows for informed clinical decision-making. Also of significance is awareness of alternate arrangements that may be encountered in terms of venous drainage, and the importance of intramural venous collecting spaces in these patterns. The objective of our review, therefore, is to explore and describe the anatomical distribution of the coronary veins.

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“…According to Ortale study [7], the most common triangle was inferiorly opened Commonly, the great cardiac vein varies with respect to presence, location and the superficial or deep relationship of single crossings of the anterior interventricular and circumflex arteries. The relations of GCV to CA and AIA, regarding to the type of crossing between vessels had been extensively studied, and the vein may cross those vessels anteriorly, posteriorly or never cross neither [8].…”

Section: Discussionmentioning

confidence: 99%