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Great cardiac vein
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The great cardiac vein is a large blood vessel found on the anterior (sternocostal) surface of the heart. The anterior interventricular vein becomes the great cardiac vein once it has left the anterior interventricular sulcus and has entered the coronary sulcus.
The great cardiac vein is one of the veins constituting the greater cardiac venous system, along with the coronary sinus, middle cardiac, small cardiac, anterior cardiac, anterior and posterior interventricular, right and left marginal, left posterior, ventricular septal veins, infundibular veins, veins of the atria, vein of Zuckerkandl, vein of Cruveilhier, and oblique vein of Marshall.
The common feature of the veins of this group is that they are located in the subepicardial part of the myocardium. The main function of the great cardiac vein is to contribute to the venous drainage of the external layer of the myocardium.
| Drains from | Small venules of the apex of heart |
| Tributaries | Venules of the ventricles and left atrium, left marginal vein, oblique vein of left atrium (of Marshall) |
| Drains to | Coronary sinus |
| Drainage area | External layer of the myocardium of the ventricles and left atrium |
This article will discuss the anatomy, course and function of the great cardiac vein.
Anatomy and course
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The great cardiac vein emerges at the apex of the heart from the small venules that collect the venous blood of this cardiac region. It ascends along the anterior surface of the heart, passing through the anterior interventricular groove accompanied by the anterior interventricular artery. Once it reaches the bifurcation of the left coronary artery, it takes a sharp course to the left crossing into the left atrioventricular groove.
The vein passes below the left auricle of the heart, emptying into the coronary sinus. Just prior to the opening into the coronary sinus, it is joined by the oblique vein of left atrium (of Marshall). Along its course, the great cardiac vein receives small tributaries from the myocardium of both ventricles and the left atrium. It also receives the venous blood from the left marginal vein.
The orifice via which the greater cardiac vein opens into the coronary sinus contains the valve of Vieussens, which is an anatomical landmark for a clear distinction between the vein and sinus. The valve usually consists of one to three leaves, and the level of its development significantly varies among people. It is important in the clinical practice as in around 40% of people, this valve impedes the surgical procedures that involve placing the electrode catheters from the coronary sinus to the greater cardiac vein.
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