The coronary sinus is located in the posterior portion of the
coronary sulcus on the diaphragmatic or posterior surface of the heart.
The coronary sinus empties directly into the right atrium near the
conjunction of the posterior interventricular sulcus and the coronary
sulcus (crux cordis area), located between the inferior vena cava and
tricuspid valve; this atrial ostium can be partially covered by a
Thebesian valve, although the anatomy of this valve is highly variable.
The coronary sinus receives drainage from most epicardial ventricular
veins, including the oblique vein of the left atrium (and other left and
right atrial veins), the great cardiac vein, the posterior vein of the
left ventricle, the left marginal vein, and the posterior
interventricular vein. The length of the coronary sinus in adults can
vary from 15 to 65 mm.
The coronary sinus serves as the primary collector of cardiac
Importance in cardiovascular diseases:
The delivery of cardioplegia
through the coronary sinus has been proven to be safe and effective in
myocardial protection, and even superior to the traditional method of
antegrade cardioplegia, especially in patients with coronary artery
Importance in device delivery:
Balloon catheters can be placed coronary sinus to deliver therapeutics,
cardioplegia buffers, or contrast agents, to obtain venograms of the heart.
Numerous device have also been deployed in the coronary sinus as a means to
structurally remodel the annulus of the mitral valve (e.g., to minimize