Morphometric and Morphological Variations of Coronary Venous System and Its Tributaries – An Anatomical Study

Abstract: Background: Knowledge of the coronary venous system (CVS) anatomy is an important factor before many electrophysiological procedures, such as CRT or ablations. Aim: To study the anatomy of the coronary venous system and its tributaries in cadaveric hearts. Methodology: Fifty-five normal formalin-fixed adult human cadaveric hearts were used in this study. The following measurements were noted: a.length of coronary sinus, b. its relation to left coronary artery, mitral valve annulus and left atrium, c. number of atrial and ventricular tributaries, d. distance and the opening angles of major tributaries from the coronary ostium, e. length and width of coronary ostium, f. Attachment of Thebesian valve. Results: a. Length of coronary sinus(CS) ranged from 2cm to 3.8cm, the mean being 2.8cm. b. Relation of coronary sinus to the left coronary artery (LCA) andmitral valve annulus was above and parallel in 100% cases. c. The number of Atrial tributariesranged from 1-2 and ventricular from 1-6. d. The mean distance ofAnterior interventricular vein (AIV),Posterior vein of the left ventricle (PVLV),Oblique vein of left atrium (OVLA),Middle cardiac vein (MCV) from the coronary ostium was 67.5mm, 32mm, 41mm, 7mm respectively. e. The average length and width of coronary ostium was 9mm and13mm respectively. f. The besian valve in 24/55 hearts was attached to the superior, right and inferior margins of the ostium. In 29/55 hearts to the inferior margin of the ostium. Conclusion: For invasive cardiologists, knowledge about CVS anatomy could add value before and during electrophysiology procedures.