Great cardiac vein
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.
Related Radiopaedia articles
Anatomy: Thoracic
- thoracic skeleton
- thoracic cage
- thoracic spine
- articulations
- muscles of the thorax
- diaphragm
- intercostal space
- intercostal muscles
- variant anatomy
- spaces of the thorax
- thoracic viscera
- tracheobronchial tree
-
lungs
-
bronchopulmonary segmental anatomy (Boyden Classification) (mnemonic)
- left lung
- right lung
- variant anatomy
- lung parenchyma
- hilum
- pleura
-
bronchopulmonary segmental anatomy (Boyden Classification) (mnemonic)
-
heart
- cardiac chambers
- heart valves
- pectinate muscles
- cardiac fibrous skeleton
-
coronary arteries
- coronary arterial dominance
- myocardial segments
-
left main coronary artery (LMCA)
- ramus intermedius artery (RI)
-
circumflex artery (LCx)
- obtuse marginal branches (OM1, OM2, etc))
- Kugel's artery
-
left anterior descending artery (LAD)
- diagonal branches (D1, D2, etc)
- septal perforators (S1, S2, etc)
-
right coronary artery (RCA)
- conus artery
- sinoatrial nodal artery
- acute marginal branches (AM1, AM2, etc)
- inferior interventricular artery (PDA)
- posterior left ventricular artery (PLV)
- congenital anomalies
- innervation of the heart
- fetal circulation
- atrial septum
- endocardium
- myocardium
-
pericardium
- epicardium
- epicardial fat pad
- pericardial space
- oblique pericardial sinus
- transverse pericardial sinus
-
pericardial recesses
- aortic recesses
- pulmonic recesses
- postcaval recess
- pulmonary venous recesses
- pericardial ligaments
- esophagus
- thymus
- breast
- blood supply of the thorax
- arteries
- veins
- superior vena cava (SVC)
- inferior vena cava (IVC)
-
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)
- cardiac veins which drain into the coronary sinus
- pulmonary veins
- thoracoepigastric vein
- lymphatics
- innervation of the thorax
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