Cardiac veins

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

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The cardiac veins return deoxygenated blood from the myocardium to the right atrium and run parallel to coronary arteries.

## Anatomy

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The components of the cardiac venous system are the following:

### Coronary sinus

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* It is present in the coronary sulcus.
* It receives most venous return of the heart.
* It empties in the right atrium.

### Great cardiac vein

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* It runs parallel to the LAD in the anterior interventricular groove.
* It drains in the coronary sinus.

### Middle cardiac vein

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* It runs parallel to the PDA in the posterior interventricular groove.
* It drains in the coronary sinus.

### Small cardiac vein

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* It runs parallel to the marginal artery.
* It drains in the coronary sinus.

### Anterior Cardiac Veins

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* Drains the anterior right ventricle.
* Empties directly in the right atrium an not in the coronary sinus.[1]

## References

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1. ↑ Morton DA, Foreman KB, Albertine KH. Chapter 4. Heart. In: Morton DA, Foreman KB, Albertine KH, eds. The Big Picture: Gross Anatomy. New York: McGraw-Hill; 2011.

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Coronary Angiography

Coronary Anatomy|

Normal coronary anatomy • Anomalous origins of coronary arteries
(Left coronary artery • Right coronary artery) • Congenital abnormalities of coronary arteries • Coronary artery segments • Cinefilm frame speed • Coronary artery dominance (Left dominance • Right dominance • Co-dominance)

TIMI Flow Grade|

TIMI flow grade 0 • TIMI flow grade 1 • TIMI flow grade 2 • TIMI flow grade 3

TIMI Frame Count|

TFC for SVG • TIMI Myocardial Frame Count • Washout TIMI Frame Count

TIMI Myocardial Perfusion Grade|

TIMI MPG 0 • TIMI MPG 1 • TIMI MPG 2 • TIMI MPG 3

Thrombus Grading|

Thrombus Grade 0 • Thrombus Grade 1 • Thrombus Grade 2 • Thrombus Grade 3 • Thrombus Grade 4 • Thrombus Grade 5 • Thrombus Grade 6

Lesion Complexity|

Type A • Type B1 • Type B2 • Type C

Dissection Classification|

Type A • Type B • Type C • Type D • Type E • Type F

Coronary Collaterals|

Grade 0 • Grade 1 • Grade 2 • Grade 3 • Rentrop and Cohen’s Collateral Classification

Lesion Morphology|

Myocardial bridge •Definitions of Preprocedural Lesion Morphology • Luminal irregularities • Disease extent • Arterial foreshortening • Infarct related artery (Culprit lesion) • Reocclusion • Restenosis • Degenerated saphenous vein graft • Coronary artery fistula

Angiographic complications|

Distal embolization • Coronary spasm • Abrupt closure • Side branch loss • Slow flow • No-reflow • Pulsatile flow • Flow deceleration • Ectasia • Intimal flap • Staining •

Performing Coronary Angiography|

Patient preparation • Catheter selection • Standard angiographic views • High risk groups • Patients with special need • Access site closure (Manual compression • Assisted compression • Closure devices) •

Quantitative Coronary Angiography (QCA)|

Minimal lumen diameter • Percent stenosis • Reference diameter • Lesion length • Residual stenosis • Average reference segment diameter • Plaque area • Plaque volume •

Contrast Media|

High-osmolar contrast media • Iso-osmolar contrast media • Low-osmolar contrast media

Left Ventriculography & Aortography|

Ejection fraction • Aortography • Quantitative Left Ventricular Analysis (LAO projection • RAO projection • LVA) • Left Ventricular Wall Motion Analysis (Normokinesia • Hypokinesia • Akinesia • Dyskinesia • Aneurysm) • Evaluation of mitral regurgitation • Evaluation of aortic regurgitation

Right Heart Catheterization|

Pressure waveforms (Right atrial pressure • Rirght ventricular pressure • Pulmonary artery pressure • Pulmonary artery wedge-pressure) • Endomyocardial biopsy

Complications|

Access site complications • Dumping • Contrast hypersensitivity • Contrast induced nephropathy • Hypotension • Hypertension • Dissection • Vessel perforation • Acute myocardial infarction • Ventricular fibrillation • Cardiac arrest • Stroke • ASD • VSD • Pulmonary emboli • Myocardial rupture • Peripheral arterial emboli • Radiation injury
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