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One hundred consecutive patients were submitted to coronary
angiography in order to evaluate the size and distribution of the coronary venous system. Utilizing the
antero-posterior view with caudation of 40 degrees and the tip of a pig-tail catheter as a reference, measures
of the length, size and distribution of the vessels were made. In 75 patients the distribution of the vessels was
similar to that described in the literature. The mean length and size of the coronary sinus were 43.7±11 and
7.3±2.1 mm respectively. The mean length and size of the great cardiac vein (comprising the anterior
interventricular vein) were 52.3±19 and 4.8±1.3 mm, respectively, while the continuation of one vessel to the
other was very smooth. The middle cardiac vein was not evident in 17 cases, hypoplasic in 5, proximally
bifurcated in 6, associated with the small cardiac vein in 4, while its outlet in the coronary sinus was with an
angulation of 90 degrees. In 2 cases a diverticulum of the coronary sinus was found.
In 25 cases single or multiple differences, compared to the classic feature, were found, including the direct
outlet of the posterior vein of the left ventricle in the coronary sinus (8 cases) and the absence of the middle
cardiac vein (1 case).
These data suggest that a detailed analysis of the coronary vein system utilising coronary angiography is
suitable for selecting patients in whom the coronary venous system is intended to be used for diagnostic or
therapeutic purposes.
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