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Anomalies of the Coronary Sinus

2006; Linguagem: Inglês

10.1515/9780773575455-016

Maude E. Abbott,

Coronary Artery Anomalies

The three remarkable cases figured opposite require a word of elucidation from the standpoint of development.The coronary sinus is derived from the transverse portion and left horn of the sinus venosus, which receives the left superior vena cava of later foetal life, and its proximal part persists in the normal human heart while the distal portion of the left superior vena cava undergoes involution but can still be traced in the tiny vestigial oblique vein of Marshall.Persistence of this entire trunk may occur as shown in Fig. 3. Further, the pulmonary veins originate as a single trunk in the center of the sinus venosus, but subsequently, on the shifting of this cavity to the right of the embryonic heart, come to lie in the posterior wall of the primitive auricle just to the left of the valvula venosa sinistra; and an arrest at this point, so that the common pulmonary vein remained in connection with the sinus venosus, would result in the very rare anomaly shown in Fig. 1.Lastly, Bela Halpert's case, shown in Fig. 2, is an exquisite example, unique in the literature, of a true congenital arteriovenous aneurysm of the coronary circulation, the result of an anomalous anastomosis in the primitive vascular network that encircles the cardiac onlage in very early embryonic life.