LVS nourishment and innervation.
The myocardium in the LVS area receives the arterial blood from perforating arteries branching off from the proximal segments of left coronary artery branches. The venous collection drains into the coronary sinus (via anterior coronary veins into the anterior interventricular vein or great cardiac vein) from the lower aspect of LVS and via noncoronary sinus tributaries from the apical aspect and septal side of LVS [43–45]. The left or right superior septal veins drain the superior third of the interventricular septum (ventricular outflow tracts). The left superior septal vein, the longest and largest intramural venous channel, can reach 2–3 mm in diameter [22] and can be used in interventional procedures [46–49]. The venous drainage from the septal summit is most commonly into the right atrium via the intramural sinus [50], also known as veins of Vieussens or communicating vein [51]. This also involves veins that drain the adipose tissue that cover the conus arteriosus [43]. An important fact is that this region is abundant in venous anastomoses with the axillary orientated circle embracing the entire heart, consisting of the coronary sinus–great cardiac vein–small cardiac vein–conus vein, and further intercommunicating veins [22].