The Venous Drainage of the Human Myocardium

Enhanced performance,evaluation,and interpretation of the various forms ofcardi­ ological diagnostic procedures and open-heart surgery, the achievement of a rapid improvement in the oxygen consumption ofhypoxic myocardium,and the salvage of viable but ischemic myocardium still appear to constitute the most important chal­ lenges to modern medicine. Research on the vascular anatomyof the myocardium has mostlybeen focused on the coronary arteries and myocardial capillaries (von Liidinghausen 2002); by com­ parison, the coronaryor cardiac venous systems have traditionally been neglected. A search through the literature of the mid-twentieth century onwards fails to reveal a detailed report on the anatomy and topography of the coronary sinus (CS) and its related veins (Smith 1962). In this area,new frontiers havebeencrossed through the useofthe technique ofCS catheterization,for instance for the purpose of: 1. Thevisualizationofthevenous partofcardiaccirculation [angiography,computed tomography (CT) I. Methods of visualization of the coronary venous drainage system using electron-beam CT and angiographical methods have recently been presented by Schaffleret al. (2000) and Sun et al. (2002). 2. Electro-physiologicalstudyoftheatrialcomponentsoftheconductionsystem.The morphologyofaccessory pathways ofthe conduction system in the neighborhood of the CS, their diagnostics and surgical treatment have been investigated and discussed by Becker et al. (1978), Seally and Mikat (1983), Robinson et al. (1988), and Sun et al. (2002).