CT features of an uncommon association between coronary-pulmonary fistula and Vieussens’ arterial ring

Cellina, Michaela; Bombaci, Francesco; Gibelli, Daniele; Marta, Patricia; Oliva, Giancarlo

doi:10.1016/j.diii.2020.03.013

Cited by 4 publications

(8 citation statements)

References 3 publications

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“…According to Chenjin Ge et al, the most frequent symptoms in patients with VAR fistulas were chest pain and dyspnoea [ 67 ]. We found that of the 13 CAF cases reported in the literature, five patients presented with angina [ 6 , 24 , 35 , 42 , 55 ], three with chest discomfort [ 25 , 36 , 37 ] and three with dyspnoea [ 25 , 28 , 46 ], whereas two were asymptomatic [ 10 , 31 ].…”

Section: Reviewmentioning

confidence: 99%

“…Lee and colleagues described the case of a 55-year-old male with infective endocarditis and severe mitral regurgitation, suggesting that in the absence of any other obvious causes, such conditions should be attributed to CAFs [ 37 ]. Sometimes, the part of the ring proximal to the fistula becomes dilated leading to aneurysm formation, plus promoting premature coronary atherosclerosis or even cardiac arrhythmia and heart failure [ 6 ].…”

Section: Reviewmentioning

confidence: 99%

“…Coronary angiography is the “gold standard” imaging modality when the evaluation of the coronary arteries is in order [ 38 ]. However, the multidetector CT complements or even competes against the established, yet invasive coronary angiography [ 9 ], as it can precisely provide an in-depth depiction of VAR origin, course, dimensions, drainage site and anatomic relations with adjacent structures [ 6 ].…”

Section: Reviewmentioning

confidence: 99%

“…Their adequacy and extent vary greatly, determining the left ventricular contractility function and the manifestation and consequence of symptoms [ 4 , 5 ]. The collateral pathway between the right and the left coronary circulation is the so-called Vieussens’ arterial ring (VAR) or the arterial circle of Vieussens [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Vieussens’ Arterial Ring: Historical Background, Medical Review and Novel Anatomical Classification

Christodoulou,

Stakos,

Androutsopoulou

et al. 2023

Cureus

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In coronary artery disease, the presence of Vieussens’ arterial ring (VAR), a ring-shaped anastomosis between the conus branch of the right coronary artery with the left anterior descending artery (LAD), will allow blood flow to return to the obstructed coronary system. We have conducted a literature review, aiming to collect all the existing information about the documented VAR cases and any related pathological conditions. A total of 54 studies entered the review, including 56 patients. The mean age of the patients was 56.12 ± 16.2 years. Angina was present in 53.6% of the patients, with 7.2% of the cases being asymptomatic. Coronary artery disease outweighed (58.9%) as the patients’ most frequent diagnosis. We propose a novel VAR anatomical classification, based on the sites of origin and termination of its course, with six distinct types, for a better understanding and surgical management of VAR. Type IA, originating from the conus branch and terminating in the proximal segment of the LAD was most frequently reported (51.8%). The recognition and the subsequent evaluation of the ring’s anatomy and course are crucial for a customized clinical intervention. When right and left coronary angiographies fail to reveal any collateral circulation, selective conus artery catheterization should be in order. The proposed classification offers a manageable and comprehensive context for the assessment, evaluation and planning of therapeutic strategies of VAR and sets a new terminology frame for treatment guidelines.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vieussens’ Arterial Ring: Historical Background, Medical Review and Novel Anatomical Classification

Christodoulou,

Stakos,

Androutsopoulou

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…CCTA has gained a major role in coronary anomalies assessment, thank high spatial and temporal resolution, and lower radiation exposure. The possibility of different types of post-processing approaches, including multiplanar and three-dimensional reconstructions, allows a precise visualization of the anatomical configuration of the coronary tree that can be difficult to identify on 2D fluoroscopic images [3] , [4] , [5] , [6] .…”

mentioning

confidence: 99%