Anterior Cardiac Veins

venae cordis anteriores

The anterior cardiac veins are two to four small veins draining the anterior right ventricular wall. They cross the right atrioventricular groove and drain directly into the anterior wall of the right atrium independently, without joining the coronary sinus. They are the only cardiac veins that bypass the coronary sinus, representing a minor but distinct venous drainage pathway. The Thebesian veins (smallest cardiac veins) similarly drain directly into all cardiac chambers.

Region: Chest

Clinical Relevance

Clinical Notes

The anterior cardiac veins and their direct drainage to the right atrium is relevant in understanding cardiac venous anatomy for surgical and electrophysiological procedures. During cardiac surgery requiring cardioplegia delivery through the coronary sinus (retrograde cardioplegia), the anterior cardiac veins that bypass the sinus represent a potential incomplete cardioplegia delivery path to the right ventricle. Their small size means this is rarely clinically significant. Recognition of these veins prevents confusion with coronary arteries during right heart dissection.

Pathology

Common Injuries & Conditions

Incomplete Right Ventricular Cardioplegia

During retrograde cardioplegia delivery through the coronary sinus, the right ventricle may be inadequately protected due to the anterior cardiac veins draining directly to the right atrium rather than through the sinus, necessitating supplemental direct right coronary artery antegrade cardioplegia delivery in complex cardiac procedures.