Angiographically detectable Thebesian veins are a dynamic and reversible finding in the setting of congenital heart disease

Tannous, Paul; Ghelani, Sunil J.; Marshall, Audrey C.; Porras, Diego

doi:10.1111/chd.12457

Cited by 5 publications

(10 citation statements)

References 10 publications

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“…4,7,10 Third, in the more recent clinical literature, the main mentions of Thebesian veins are related to accidental penetration of the subendocardium by inappropriate catheters during LV angiography 1,11 or in the context of rare accompanying defects. 3,12,13 Fourth, another modern experimental study on sheep hearts suggested that Thebesian foramina could be seen in both ventricular chambers. 2 By injecting India ink into each coronary artery in autopsied hearts, the investigator identified communications between the coronary arteries and cardiac chambers (arterioluminal vessels) and between the coronary veins and cardiac chambers (venoluminal vessels) in 16 of 36 hearts.…”

Section: Editorialmentioning

confidence: 99%

“…9 Moreover, the clinical relevance of these malformations is trivial in the framework of the entire coronary circulation. The occasionally mentioned coronary steal attributed to preferential flow into cardiac cavities from nutrient branches 3,12,13 is probably an erroneous description, because Fig. 2 Original drawings of a heart from Thebesius' dissertation, 10 including a cadaveric left ventricle (left) cut in the sagittal plane (apical view).…”

Section: Editorialmentioning

confidence: 99%

“…An exception to our arguments against the existence of Thebesian veins in normal hearts can be found in patients with complex congenital heart disease. In a series of infant cases from Boston Children's Hospital, 13 noncompaction cardiomyopathy appeared to be part of various complex and associated myocardial malformations. However, the observed arteriovenous communications were probably multiple coronary artery-to-LV microfistulae of benign importance.…”

Section: Reprinted With Permission From Saremi F Et Al Coronary Veins: Comprehensive Ct-anatomic Classification and Review Of Variants Anmentioning

confidence: 99%

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Another Mention of Thebesian Veins in the Heart: Should It Be the Last?

Angelini¹,

Uribe²

2021

Texas Heart Institute Journal

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Arecent article 1 revisited the existence, nature, and imaging of so-called Thebesian veins, a phantomlike entity that has been mentioned in the medical literature since the early 1700s. In that article, Potu and colleagues 1 describe the incidental cannulation of a left ventricular (LV) Thebesian vein during LV angiography. The flow rate in the mechanical contrast injector was set at 10 mL/s, which may have produced a jet pressure at the tip of the catheter (a right coronary 5F JR4) that was high enough to cause the catheter to whip around and penetrate a newly developed subendocardial space. As the cineangiogram shows, 1 the compression of this intramural vesicle (or tear) during systole did not result in chronic, persistent drainage into the LV cavity, but only slow drainage into preexisting, connected small posterior cardiac veins and ultimately into the coronary sinus. The injected contrast dye cleared in approximately 30 seconds. Chest pain and electrocardiographic changes during such a generally benign event are rare.

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Section: Editorialmentioning

confidence: 99%

Section: Editorialmentioning

confidence: 99%

Section: Reprinted With Permission From Saremi F Et Al Coronary Veins: Comprehensive Ct-anatomic Classification and Review Of Variants Anmentioning

confidence: 99%

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Another Mention of Thebesian Veins in the Heart: Should It Be the Last?

Angelini¹,

Uribe²

2021

Texas Heart Institute Journal

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“…Forgotten knowledge of the coronary-cameral connections and the rediscovery of their dynamic nature in development: The result of a misnomer, ambiguous use of nomenclature, and varied evaluation methods To the Editor, Tannous et al report a case series that utilizes a semiquantitative grading system for following children with congenital heart disease and connections between the coronary arteries and heart chambers as identified on coronary artery angiography. 1 However, the authors are not the first to demonstrate the dynamic nature of the coronary artery-cameral connections. 2,3 In addition, Sirker et al reported a case of coronary artery fistula that was initially grade zero and then progressed to a higher grade.…”

mentioning

confidence: 99%

“…5 Tannous et al astutely noted that there is a difference between the arterioluminal and venoluminal connections. 1 However, they mistakenly refer to both types of connections as "thebesian veins," and cite a reference that utilizes inaccurate nomenclature. 6 Thebesius did not study the arterioluminal connections, and the arterioluminal connections are not veins ( Figure 1).…”

mentioning

confidence: 99%

Forgotten knowledge of the coronary-cameral connections and the rediscovery of their dynamic nature in development: The result of a misnomer, ambiguous use of nomenclature, and varied evaluation methods

Snodgrass¹,

Chilakala²

2017

Congenital Heart Disease

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Response by Kim et al. to Letter regarding article, “Prominent Thebesian veins, a rare congenital coronary anomaly presenting as acute myocardial ischemia”

Kim

Cho

et al. 2020

Journal of Cardiology Cases

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The vessels of Wearn include the arterioluminal and arteriosinusoidal vessels and they are not Thebesian veinsWe read the article by Kim et al., and are obliged to clarify certain terms used therein [1]. The term "arterioluminal vessel" was introduced by Wearn in 1933 and contained two definitions [2]. For clarity, Wearn subclassified the aformentioned vascular communications between coronary arteries and heart chambers into the arterioluminal and arteriosinusoidal vessels [2]. For disambiguation, the term "vessels of Wearn" has been used to encompass the arterioluminal and arteriosinusoidal vessels. The 1933 article by Wearn notes that it was 1706 when the coronary artery-cameral connections were first reported by Raymond Vieussens [2,3]. The 1708 publication by Thebesius was about a study that discovered the coronary vein-cameral connections, which have been eponymously referred to as Thebesian veins [4].It is fundamentally erroneous to classify an arterioluminal and/ or arteriosinusoidal vessel as a Thebesian vein. However, careful review of the original report published in 1933 by Wearn, i.e., the report that introduced the terms arterioluminal and arteriosinusoidal, should provide the reader and future authors with a uniform nomenclature.Also, many of the connections reported by Kim et al. may be of the arteriosinusoidal and not the arterioluminal subtype of the vessels of Wearn. The arteriocapillary connections were inaccurately reported as a type of Thebesian vein by Kim et al., and the possibility of an arteriocapillary type of coronary artery-cameral connection may warrant further study [1]. Parenthetically, coronary arteries normally flow toward coronary capillaries. Capillaries could theoretically transmit flow into the cardiac lumen in a manner similar to the myocardial sinusoids [2]. Regardless, none of the three terms reported by Kim et al. as Thebesian veins are properly attributable to Thebesius [1].The authors of this letter have been trying to correct the erroneous and misleading nomenclature that refers to the coronary artery-cameral connections "vessels of Wearn" as valveless Thebesian veins. Arteries and their tributaries are considered valveless. Thus, using the term "valveless Thebesian vein" to refer to a type of coronary artery-cameral connection facilitates obfuscation and not clarity. The word "valveless" is irrelevant, the word "Thebesius" incorrectly suggests that the artery-cameral connections were discovered by Thebesius, and the word "vein" misrepresents the nature of the vascular connection. We plead for authorship and advocacy by others to help create and establish medical terminology that is an accurate reflection of reality [5]. With the international use of consistent medical terminology, the natural history, prevalence, and prognosis should

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Angiographically detectable Thebesian veins are a dynamic and reversible finding in the setting of congenital heart disease

Cited by 5 publications

References 10 publications

Another Mention of Thebesian Veins in the Heart: Should It Be the Last?

Another Mention of Thebesian Veins in the Heart: Should It Be the Last?

Forgotten knowledge of the coronary-cameral connections and the rediscovery of their dynamic nature in development: The result of a misnomer, ambiguous use of nomenclature, and varied evaluation methods

Response by Kim et al. to Letter regarding article, “Prominent Thebesian veins, a rare congenital coronary anomaly presenting as acute myocardial ischemia”

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