Smallest cardiac veins

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Smallest cardiac veins
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Identifiers
Latin venae cardiacae minimae,
venae cordis minimae
TA98 A12.3.01.013
TA2 4169
FMA 71568
Anatomical terminology

The smallest cardiac veins (also known as the Thebesian veins (named for Adam Christian Thebesius)) are small, valveless veins in the walls of all four heart chambers [1] that drain venous blood from the myocardium [2] directly into any of the heart chambers. [3]

Contents

They are most abundant in the right atrium, and least abundant in the left ventricle. [4] [ better source needed ]

Structure

The smallest cardiac veins vary greatly in size and number. Those draining the right atrium have a lumen of up to 2 mm in diameter, whereas those draining the right ventricle have lumens as small as 0.5 mm in diameter. [5]

Course

They run a perpendicular course to the endocardial surface, directly connecting the heart chambers to the medium-sized, and larger coronary veins. [6]

Openings

The openings of the smallest cardiac veins are located in the endocardium. Here the smallest cardiac veins return blood into the heart chambers from the capillary bed in the muscular cardiac wall, enabling a form of collateral circulation unique to the heart. Not every endocardial opening connects to the smallest cardiac veins, as some connect to the vessels of Wearn, which are arteries. Therefore, the endocardial opening must be traced to a vein before it is definitely called an opening of the smallest cardiac veins.[ citation needed ]

Function

The small cardiac veins are responsible for venous return of 10% of the coronary blood supply. [7] The small cardiac venous network is considered an alternative venous drainage of the myocardium. The smallest cardiac veins draining into the left heart, along with deoxygenated blood originating from the bronchial veins draining into the pulmonary veins, contribute to normal physiologic shunting of blood. As a consequence of the input of these vessels, blood in the left heart is less oxygenated than the blood found at the pulmonary capillary beds, usually to a very small degree.

History

Etymology

The smallest cardiac veins are also known as the Thebesian veins. [8] [9] They are named after the German anatomist Adam Christian Thebesius, who described them in a 1708 treatise called Disputatio medica inauguralis de circulo sanguinis in corde. [10] [11]

Mislabelling

The smallest cardiac veins are sometimes accurately referred to as vessels, but they are frequently confused with a distinct set of artery connections, [12] [13] [14] [15] eponymously referred to as the "vessels of Wearn". [16] In his 1928 publication, Wearn himself referred to the arterio-cameral connections (vessels of Wearn) as Thebesian, [17] but later, after additional research, provided disambiguation and strictly used the term Thebesian for coronary vein-heart chamber connections. [18]

Related Research Articles

<span class="mw-page-title-main">Heart</span> Organ found inside most animals

The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to the lungs. In humans, the heart is approximately the size of a closed fist and is located between the lungs, in the middle compartment of the chest, called the mediastinum.

<span class="mw-page-title-main">Vein</span> Blood vessels that carry blood towards the heart

Veins are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins.

<span class="mw-page-title-main">Circulatory system</span> Organ system for circulating blood in animals

The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, that consists of the heart and blood vessels. The circulatory system has two divisions, a systemic circulation or circuit, and a pulmonary circulation or circuit. Some sources use the terms cardiovascular system and vascular system interchangeably with the circulatory system.

<span class="mw-page-title-main">Coronary circulation</span> Circulation of blood in the blood vessels of the heart muscle (myocardium)

Coronary circulation is the circulation of blood in the arteries and veins that supply the heart muscle (myocardium). Coronary arteries supply oxygenated blood to the heart muscle. Cardiac veins then drain away the blood after it has been deoxygenated. Because the rest of the body, and most especially the brain, needs a steady supply of oxygenated blood that is free of all but the slightest interruptions, the heart is required to function continuously. Therefore its circulation is of major importance not only to its own tissues but to the entire body and even the level of consciousness of the brain from moment to moment. Interruptions of coronary circulation quickly cause heart attacks, in which the heart muscle is damaged by oxygen starvation. Such interruptions are usually caused by coronary ischemia linked to coronary artery disease, and sometimes to embolism from other causes like obstruction in blood flow through vessels.

<span class="mw-page-title-main">Coronary artery bypass surgery</span> Surgical procedure to restore normal blood flow to an obstructed coronary artery

Coronary artery bypass surgery, also known as coronary artery bypass graft, is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pain caused by CAD, slow the progression of CAD, and increase life expectancy. It aims to bypass narrowings in heart arteries by using arteries or veins harvested from other parts of the body, thus restoring adequate blood supply to the previously ischemic heart.

<span class="mw-page-title-main">Air embolism</span> Vascular blockage by air bubbles

An air embolism, also known as a gas embolism, is a blood vessel blockage caused by one or more bubbles of air or other gas in the circulatory system. Air can be introduced into the circulation during surgical procedures, lung over-expansion injury, decompression, and a few other causes. In flora, air embolisms may also occur in the xylem of vascular plants, especially when suffering from water stress.

<span class="mw-page-title-main">Pulmonary artery</span> Artery in pulmonary circulation carrying deoxygenated blood from heart to lungs

A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the main pulmonary artery or pulmonary trunk from the heart, and the smallest ones are the arterioles, which lead to the capillaries that surround the pulmonary alveoli.

<span class="mw-page-title-main">Cardiac catheterization</span> Insertion of a catheter into a chamber or vessel of the heart

Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes.

<span class="mw-page-title-main">Jugular vein</span> Veins that bring deoxygenated blood from the head back to the heart

The jugular veins are veins that take deoxygenated blood from the head back to the heart via the superior vena cava. The internal jugular vein descends next to the internal carotid artery and continues posteriorly to the sternocleidomastoid muscle.

<span class="mw-page-title-main">Atrium (heart)</span> Part of the human heart

The atrium is one of the two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular mitral and tricuspid heart valves.

<span class="mw-page-title-main">Transposition of the great vessels</span> Group of congenital heart defects

Transposition of the great vessels (TGV) is a group of congenital heart defects involving an abnormal spatial arrangement of any of the great vessels: superior and/or inferior venae cavae, pulmonary artery, pulmonary veins, and aorta. Congenital heart diseases involving only the primary arteries belong to a sub-group called transposition of the great arteries (TGA), which is considered the most common congenital heart lesion that presents in neonates.

<span class="mw-page-title-main">Coronary sinus</span> Set of veins which drain blood from the myocardium (heart muscle)

The coronary sinus is the largest vein of the heart. It drains over half of the deoxygenated blood from the heart muscle into the right atrium. It begins on the backside of the heart, in between the left atrium, and left ventricle; it begins at the junction of the great cardiac vein, and oblique vein of the left atrium. It receives multiple tributaries. It passes across the backside of the heart along a groove between left atrium and left ventricle, then drains into the right atrium at the orifice of the coronary sinus.

A right-to-left shunt is a cardiac shunt which allows blood to flow from the right heart to the left heart. This terminology is used both for the abnormal state in humans and for normal physiological shunts in reptiles.

<span class="mw-page-title-main">Great cardiac vein</span>

The great cardiac vein is a vein of the heart. It begins at the apex of the heart and ascends along the anterior interventricular sulcus before joining the oblique vein of the left atrium to form the coronary sinus upon the posterior surface of the heart.

<span class="mw-page-title-main">Valve of coronary sinus</span> Fold in the interior lining of the right atrium of the heart

In the anatomy of the heart, the valve of the coronary sinus is a valve located at the orifice of the coronary sinus where the coronary sinus drains into the right atrium. It prevents blood from flowing backwards into the coronary sinus during contraction of the heart.

<span class="mw-page-title-main">Circumflex branch of left coronary artery</span> Artery of heart

The circumflex branch of left coronary artery is a branch of the left coronary artery. It winds around the left side of the heart along the atrioventricular groove. It supplies the posterolateral portion of the left ventricle.

<span class="mw-page-title-main">Left anterior descending artery</span> Artery of the heart

The left anterior descending artery is a branch of the left coronary artery. It supplies the anterior portion of the left ventricle. It provides about half of the arterial supply to the left ventricle and is thus considered the most important vessel supplying the left ventricle. Blockage of this artery is often called the widow-maker infarction due to a high risk of death.

The Senning procedure is an atrial switch heart operation performed to treat transposition of the great arteries. It is named after its inventor, the Swedish cardiac surgeon Åke Senning (1915–2000), also known for implanting the first permanent cardiac pacemaker in 1958.

<span class="mw-page-title-main">Heart development</span> Prenatal development of the heart

Heart development, also known as cardiogenesis, refers to the prenatal development of the heart. This begins with the formation of two endocardial tubes which merge to form the tubular heart, also called the primitive heart tube. The heart is the first functional organ in vertebrate embryos.

The heart is a muscular organ situated in the mediastinum. It consists of four chambers, four valves, two main arteries, and the conduction system. The left and right sides of the heart have different functions: the right side receives de-oxygenated blood through the superior and inferior venae cavae and pumps blood to the lungs through the pulmonary artery, and the left side receives saturated blood from the lungs.

References

  1. ↑ Blake, HA; Manion, WC; Mattingly, TW; Baroldi, G (1964). "Coronary artery anomalies". Circulation. 30 (6): 927–40. doi: 10.1161/01.cir.30.6.927 . PMID   14246341.
  2. ↑ Agur, AMR; Dalley, AF (2009). Grant's atlas of anatomy. Lippincott Williams & Wilkins. pp. 53–. ISBN   978-0-7817-7055-2 . Retrieved 31 October 2010.
  3. ↑ Wilson, Alexander; Bhutta, Beenish S. (2022), "Anatomy, Thorax, Coronary Sinus", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32491498 , retrieved 2023-01-05
  4. ↑ "Venae cordis minimae". radiopaedia.org. Retrieved 31 August 2019.
  5. ↑ Standring, Susan (2020). Gray's Anatomy: The Anatomical Basis of Clinical Practice (42th ed.). New York. p. 1093. ISBN   978-0-7020-7707-4. OCLC   1201341621.{{cite book}}: CS1 maint: location missing publisher (link)
  6. ↑ Pratt, FH (1898). "The nutrition of the heart through the vessels of Thebesius and the cardiac veins" (PDF). American Journal of Physiology. 1: 86–103. doi:10.1152/ajplegacy.1898.1.1.86.
  7. ↑ Wilson, Alexander; Bhutta, Beenish S. (2022), "Anatomy, Thorax, Coronary Sinus", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32491498 , retrieved 2023-01-05
  8. ↑ Singhal, S; Khoury, S (2008). "Images in clinical medicine. Imaging of thebesian venous system". The New England Journal of Medicine. 359 (7): e8. doi:10.1056/nejmicm072885. PMID   18703466.
  9. ↑ Smith, TM (2009). "Rare view of thebesian venous system". Radiologic Technology. 81 (2): 173–4. PMID   19901354.
  10. ↑ synd/4013 at Who Named It?
  11. ↑ Thebesius, AC (1708). Disputatio medica inauguralis de circulo sanguinis in corde. Doctoral dissertation, Leiden.
  12. ↑ Boeder, NF; Nef, HM; Bauer, T (2016). "Thebesian veins as drainage to the ventricle: A case report". Cardiovascular Revascularization Medicine. 18 (3): 213–214. doi:10.1016/j.carrev.2016.09.007. PMID   27743821.
  13. ↑ Grollman, JH Jr (1998). "Re: three major coronary artery-to-left ventricular shunts". CardioVascular and Interventional Radiology. 21 (2): 183. doi:10.1007/s002709900240. PMID   9502691. S2CID   40212007.
  14. ↑ Wearn, JT (1941). "Morphological and functional alterations of the coronary circulation". Bulletin of the New York Academy of Medicine. 17 (10): 754–777. PMC   1933738 . PMID   19312228.
  15. ↑ Wearn, JT; Mettier, SR; Klumpp, TG; Zschiesche, LJ (1933). "The nature of the vascular communications between the coronary arteries and the chambers of the heart". American Heart Journal. 9 (2): 143–164. doi: 10.1016/S0002-8703(33)90711-5 .
  16. ↑ Hussain, M; Roberts, EB (2015). "Association of coronary to left ventricular microfistulae (vessels of Wearn) with atrial septal defect in an adult without cyanotic heart disease". BMJ Case Reports. 2015: bcr2014207655. doi:10.1136/bcr-2014-207655. PMC   4493239 . PMID   26139649.
  17. ↑ Wearn, JT (1928). "The role of the thebesian vessels in the circulation of the heart". Journal of Experimental Medicine. 47 (2): 293–315. doi: 10.1084/jem.47.2.293 . PMC   2131354 . PMID   19869414.
  18. ↑ Wearn, JT; Mettier, SR; Klumpp, TG; Zschiesche, LJ (1933). "The nature of the vascular communications between the coronary arteries and the chambers of the heart". American Heart Journal. 9 (2): 143–164. doi: 10.1016/S0002-8703(33)90711-5 .
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