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. 2025 Jul 29;47(1):182.
doi: 10.1007/s00276-025-03691-z.

Anatomy of the oblique vein of the left atrium: contribution of microCT analysis of human hearts

Anaïs Delgove  1   2 , Richard Walton  3 , Nestor Pallares-Lupon  3 , Valéry Ozenne  3   4 , Marion Constantin  3 , Marine Arnaud  3   5 , Ewen Le Quilliec  3 , Michel Haïssaguerre  3   5 , Mélèze Hocini  3   5 , Pierre Jaïs  3   5 , Nicolas Derval  3   5 , Thomas Pambrun  3   5 , Olivier Bernus  3 , Josselin Duchâteau  3   5
Affiliations

Anatomy of the oblique vein of the left atrium: contribution of microCT analysis of human hearts

Anaïs Delgove et al. Surg Radiol Anat. .

Abstract

Introduction: The oblique vein of the left atrium (OVLA), also known as the vein of Marshall, is an embryonic remnant of interest to cardiac electrophysiologists. The aim of this cadaveric study was to describe the anatomy of the OVLA and its relationship with the left atrial wall using micro-CT.

Material and methods: The OVLA was selectively injected with a baryum-gelatin mixture, then the specimen was bathed in a Lugol's solution and imaged with micro-CT at an isotropic resolution of 42 µm. In addition to qualitative descriptions of the relationship between the vein and the surrounding musculature, quantitative measures of the veins' dimensions were obtained.

Results: Eighteen hearts were analyzed. The mean length of the OVLA main axis was 36.5 ± 19.4 mm. Analysis of OVLA segmentations showed heterogeneous arborization. The main axis, oblique towards the ridge, was variable in length. It was short in 3 specimens and reached the roof of the atrium in 4 cases. The main branch received short collateral branches localized near the pulmonary veins (N = 5), or long collaterals from the posterior wall (N = 3). Myocardial tissue was consistently found at different level surrounding the vein, separated from the compact endocardium by fatty tissue.

Discussion: This is the first anatomical study of the oblique vein of the left atrium using micro-CT after selective injection. It enabled very high-resolution analysis of the OVLA and showed heterogeneous lengths and arborizations, up to the roof or posterior wall of the left atrium. The veins colocalizes with non-compact muscular tissue relevant to cardiac electrophysiology.

Keywords: Alcoolization; Anatomy; Atrial fibrillation; Micro-CT; Oblique vein of the left atrium; Radiofrequency ablation; Vein of Marshall.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no financial or non-financial interests related to this work.

References

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