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Great cardiac vein

Dr Francis Deng and Dr Matt A. Morgan ◉ et al.

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 azygous 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

Anatomy: Thoracic

thoracic skeleton
- thoracic cage
  - ribs
    - typical ribs
    - atypical ribs
    - variant anatomy
      - bifid ribs
      - Srb anomaly
  - costal cartilage
  - sternum
- thoracic spine
- articulations
muscles of the thorax
spaces of the thorax
thoracic viscera
blood supply of the thorax
- arteries
  - thoracic aorta (development)
  - pulmonary trunk
    - left pulmonary artery
      - aberrant left pulmonary artery
    - right pulmonary artery
- veins
  - superior vena cava (cavoatrial junction)
  - inferior vena cava
  - coronary veins
    - cardiac veins which drain into the coronary sinus
      - great cardiac vein
      - middle cardiac vein
      - small cardiac vein
      - posterior vein of the left ventricle
      - vein of Marshall (oblique vein of the left atrium)
    - anterior cardiac veins
    - venae cordis minimae (smallest cardiac veins or thebesian veins)
  - pulmonary veins
    - bronchial veins
lymphatics
innervation of the thorax

Article information

rID: 34284

System: Vascular, Cardiac

Section: Anatomy

Tag: cardiac, heart, cardiac anatomy, cardiac veins

Synonyms or Alternate Spellings:

GCV
left coronary vein

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Cases and figures

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