The great cardiac vein is the longest venous vessel of the heart; in the majority of our cases it originated at the lower third of the anterior interventricular sulcus (58%). The great and the middle cardiac veins merge at the apex of the heart, forming together with the coronary sinus into which they both empty, a complete venous ring around the left ventricle (13%). On reaching the area of the coronary sulcus, the great cardiac vein crosses the anterior interventricular branch and the circumflex branch of the left coronary artery forming the triangle of Brocq and Mouchet in which the vein is mainly superficial (61%). One, two or three anterior ventricular branches of the left coronary artery traverse this triangle; the relations of the vein and these arteries are very variable and practically unpredictable in 30% of the cases.
Classic anatomical dissection of 150 hearts from adults aged 18 -80 years was performed. The sinoatrial (SA) node artery was most frequently a large atrial branch of the right coronary artery (63%), arising at a mean distance of 1.2 cm (range 0.2 -2.2 cm) from its beginning, with a mean external diameter of 1.7 mm (range 1 -3 mm). In 37% of cases the SA node artery was a branch of the left coronary artery or one of its branches, with an initial mean external diameter of 2.2 mm (range 2 -3 mm). The origin of the SA node artery was not related to coronary arterial dominance. The atrioventricular (AV) node artery was the first and longest inferior septal perforating branch of the right (90%) or left (10%) coronary artery, arising from the U-or Vshaped segment of the corresponding artery at the level of the crux cordis. Mean external diameter was 2 mm (range 1 -3.5 mm). The origin of the AV node artery was dependent on coronary arterial dominance. Identification of the anatomical variants of the arterial blood supply to the SA and AV nodes may help in overcoming potential difficulties in treating arrhythmias and in mitral valve surgery.
Classic anatomical dissection of 150 heart specimens from adults aged 18 - 80 years was performed. The Thebesian valve was absent in 20% of cases and, in these, 4% had a large ostial valve of the middle cardiac vein in front of the coronary sinus ostium. Fibres of Chiari were found in 10% of cases. Ostia of the middle cardiac vein, posterior veins of the left ventricle, small cardiac vein and deep cardiac veins were present in the distal 10 mm of the coronary sinus. Some samples had ostial and/or parietal valves or antivalves that sometimes contained muscular fibres. Distal accessory parietal valves (2%) and antivalves (1%) of the coronary sinus wall were found at a distance of 4 - 7 mm from its ostium. The frequency and variability of anatomical structures in the area of the coronary sinus ostium probably influence the haemodynamics of this area. Knowledge of and being able to identify these anatomical variations may help in identifying and overcoming potential difficulties in treating arrythmias and in cardiosurgery.
Classic anatomical dissection of 150 heart specimens from adults aged 18 - 80 years was performed. Anatomical variations were studied in: (i) the position of the ostium of the left coronary artery; (ii) the angle between the proximal segment of the left coronary artery and the longitudinal axis of the aorta and between the circumflex and the anterior descending branches; (iii) the angle between the anterior descending artery and the diagonal branches, and between the diagonal and circumflex branches in trifurcation of the left coronary artery; (iv) the position of the ostium of the right coronary artery in the right coronary sinus of Valsalva; (v) the angle between the initial part of the right coronary artery and the longitudinal axis of the aorta; and (vi) the position of the initial part of the left coronary artery relative to the coronary groove. Knowledge of and the ability to recognize and identify the variety of sites of origin of coronary arteries, aortocoronary angles and angles of division of the left coronary artery of the human heart may help to overcome potential difficulties in cardiosurgical procedures, such as aortic valve replacement and reinsertion of coronary arteries.
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