Cardiac Structural Changes and Long-Term Survival in Patients With Prominent Thebesian Veins

Snipelisky, David; Reddy, Yogesh N.V.; Lennon, Ryan J.; Crusan, Daniel J.; Rihal, Charanjit S.; Lapeyre, André C.

doi:10.1016/j.amjcard.2016.07.038

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…5,6 Despite a few claims that Thebesian veins increase morbidity and mortality, a study of more than 50,000 patients who underwent coronary angiography revealed that only 0.06% had prominent Thebesian veins; when compared with a matched control group of almost 600 patients without such Thebesian veins, the study group was not at greater risk of death. 8 Similar statements about the anatomy and function of Thebesian veins have been published, despite trivial (if any) supporting evidence, particularly from histologic imaging. Current cardiac anatomy and physiology textbooks generally do not mention such structures in the normal heart.…”

Section: Thebesian Veins: a Brief Historymentioning

confidence: 69%

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: Thebesian Veins: a Brief Historymentioning

confidence: 69%

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

Angelini¹,

Uribe²

2021

Texas Heart Institute Journal

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“…Coronary arterial fistulae can contribute to worsening symptoms of heart failure. 19,20 We need to avoid hypoxia and maintain oxygen saturation levels as high as possible using home oxygen therapy. We also need to evaluate the pulmonary circulation and keep in mind to make appropriate use of pulmonary vasodilators.…”

Section: Discussionmentioning

confidence: 99%

Acquired and progressive coronary arterial fistulae in patients with single-ventricle physiology and treated with pulmonary vasodilators

et al. 2021

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Background: Cardiac dysfunction, arrhythmia, and hepatic fibrosis are well-known complications after right heart bypass surgery in patients with single-ventricle physiology. However, little is known about coronary arterial fistulae, and only a few reports have been published. This study aimed to elucidate the clinical characteristics of these rare coronary arterial fistulae that developed as complications in cases of single-ventricle physiology after right heart bypass surgery. Methods: We retrospectively investigated the clinical features and courses of patients who developed acquired and progressive coronary arterial fistulae after right heart bypass surgery in our hospital. Results: We identified three cases of coronary arterial fistulae out of 21 patients who underwent right heart bypass surgery. All three cases underwent cardiac catheterisation for post-operative evaluation and were administered pulmonary vasodilators of phosphodiesterase type V inhibitors, antiplatelet, anticoagulation, and diuretics. Moreover, they had common clinical features such as right-dominant single ventricle and long-term exposure to chronic hypoxia. Serial angiograms revealed acquired and progressive coronary arterial fistulae. In addition, coronary arterial fistulae contributed to their symptoms of heart failure. Conclusion: Patients with chronic hypoxia and dominant right ventricle, who are treated with phosphodiesterase type V inhibitors, should be followed up after right heart bypass surgery to monitor the possible development of coronary arterial fistulae. Moreover, the indication for pulmonary vasodilators in single-ventricle physiology after right heart bypass surgery should be optimised to avoid adverse effects.

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The Prognosis of Thebesian Veins Can Be Obfuscated by Conflating the Vessels (Veins) of Thebesius With Coronary Artery-Cameral Connections

Snodgrass¹

2017

The American Journal of Cardiology

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Cardiac Structural Changes and Long-Term Survival in Patients With Prominent Thebesian Veins

Cited by 5 publications

References 13 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?

Acquired and progressive coronary arterial fistulae in patients with single-ventricle physiology and treated with pulmonary vasodilators

The Prognosis of Thebesian Veins Can Be Obfuscated by Conflating the Vessels (Veins) of Thebesius With Coronary Artery-Cameral Connections

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