Great cardiac vein

Last revised by Bálint Botz on 28 Jun 2021

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:

Variant anatomy

Knowledge of variants may be useful for preoperative planning.

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