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Anterior Cardiac Vein

Figure 1. Example of antegrade perfusion via the arterial LAD-catheter. (a) and retrograde perfusion of the same area via the anterior interventricular vein. (b) in a patient undergoing high-risk PTCA. (c) During balloon dilation, a significantly prolonged interval with maintained myocardial function of the area at risk for ischemia is demonstrated when oxygenized blood is retroinfused (similar to the autoperfusion catheter)

Anterior Cardiac Vein

Figure 1. Example of antegrade perfusion via the arterial LAD-catheter. (a) and retrograde perfusion of the same area via the anterior interventricular vein. (b) in a patient undergoing high-risk PTCA. (c) During balloon dilation, a significantly prolonged interval with maintained myocardial function of the area at risk for ischemia is demonstrated when oxygenized blood is retroinfused (similar to the autoperfusion catheter)

in pigs the great cardiac vein joins the hemiazygos vein to contribute to the coronary sinus draining then into the right atrium, the hemiazygos vein does not drain into the coronary sinus in dogs and in humans. With regard to selective retroinfusion of cardiac veins, the great cardiac vein and the anterior cardiac vein are highly consistent in all species and particularly in humans (Figure 1). However, there are considerable variations of the left marginal vein draining the lateral left ventricular wall. In a significant percentage of cases (38%), the left marginal vein did not exist or the myocardium is drained by several very small branches from the adjacent venous stems. The right coronary vein usually does not drain into the coronary sinus but has a separate orifice opening into the right atrium adjacent to the orifice of the coronary sinus [5]. Therefore, catheter access to the right coronary veins is technically challenging though often feasible in patients [6].

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