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Topic

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Right marginal vein of heart

The right marginal vein is a prominent tributary of the small cardiac vein that runs along the acute margin of the heart. It begins at the apex of the right ventricle, ascends along the right margin of the heart parallel to the right marginal artery (branch of the right coronary artery), and drains into the small cardiac vein, which ultimately empties into the coronary sinus.

This vein contributes to venous drainage of the right ventricle, particularly the anterior and lateral surfaces, and forms an important part of the coronary venous system, which returns deoxygenated blood from the myocardium into the right atrium. The right marginal vein is clinically relevant in cardiac venous mapping for CRT (cardiac resynchronization therapy), coronary venous interventions, and venous phase imaging.

Synonyms

  • Right marginal branch of the small cardiac vein

  • Acute marginal vein

  • Marginal vein of right ventricle

Function

  • Drains venous blood from the anterior and lateral right ventricle

  • Empties into the small cardiac vein, which joins the coronary sinus

  • Participates in myocardial venous return to the right atrium

  • Acts as a landmark in cardiac venous mapping during interventions

Branches & Connections

  • Often communicates with anterior cardiac veins draining directly into the right atrium

  • Courses alongside the right marginal artery (branch of RCA), forming an artery-vein pair

MRI Appearance

T1-weighted images (non-contrast):

  • Lumen appears as a signal void (black) due to venous flow

  • Vessel wall is thin and hypointense, outlined by epicardial fat

T2-weighted images:

  • Flow void maintained

  • Perivascular edema or pathology may appear hyperintense

STIR (Short Tau Inversion Recovery):

  • Suppresses fat signal, helping delineate venous structures

  • Adjacent edema or inflammatory changes appear bright hyperintense

MRI Non-Contrast Cardiac-Gated 3D Coronary Venography:

  • ECG-gated 3D whole-heart acquisition shows the right marginal vein as a bright linear venous channel running along the acute margin

  • Useful for mapping coronary venous anatomy pre-CRT or venous interventions

  • Demonstrates relationship to the small cardiac vein and coronary sinus

CT Appearance

Non-contrast CT:

  • Difficult to visualize unless calcifications or surrounding fat contrast is present

  • Appears as a small soft tissue density at the acute margin of the RV

CT Coronary Venography (CCTA in venous phase):

  • Provides high-resolution mapping of the right marginal vein course and connections

  • Shows drainage into the small cardiac vein and coronary sinus

  • Useful for CRT lead placement planning, venous anomalies, or coronary venous interventions

CT image

Right marginal vein of heart CT axial image -img-00000-00000

MRI image

Right marginal vein of heart