Anomalous great cardiac vein.

Anomalous coronary venous anatomy is a little studied and rarely reported subject that is of crucial importance in interventions that rely upon the assumption of normal coronary venous anatomy. In particular, the recognition of coronary vein anomalies that disconnect large segments of the left ventricular myocardium from the main coronary sinus is critical for cardiothoracic surgeons who perform interventions involving retrograde cardioplegia and other forms of coronary venous retroperfusion. We present a rare case of an anomalous great cardiac vein that bypassed the coronary sinus to drain directly into the superior vena cava, and suggest a possible role for antecedent imaging of the coronary venous system in patients who might be expected to undergo such interventions.