<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Coronary fistulas are rare, not gender-specific congenital conditions, consisting of communications between the coronary arteries and either another coronary vessel or a cardiac chamber. In contrast to large fistulas, small fistulas, named “minimae cordis veneae” or the Thebesius venous system, are draining into heart chambers and form a vascular network in the cardiac lumen. In this article, we present the case of a 72-year-old female with a significant history of cardiovascular disease, admitted to our clinic because of rest dyspnea, fatigue, and minimal chest pain. The 12-lead electrocardiogram showed a trifascicular block (a second-degree atrioventricular block Mobitz II, associated with a right bundle branch block and left anterior fascicle block) and negative T waves in DII, DIII, aVF, V4–V6 leads. An invasive coronary angiography was performed, which revealed no significant atherosclerotic lesions. However, a persistent capillary blush was present at the apex site of the left ventricular chamber, draining from the distal segments of both the anterior descending coronary artery and the posterior interventricular coronary artery. The intramural vascular network generating a left ventricle angiogram image of this kind was suggestive for persistent Thebesian vessels connecting the two coronaries with the left ventricular chamber.</p></abstract>

Coronary fistulas are rare, not gender-specific congenital conditions, consisting of communications between the coronary arteries and either another coronary vessel or a cardiac chamber. In contrast to large fistulas, small fistulas, named “minimae cordis veneae” or the Thebesius venous system, are draining into heart chambers and form a vascular network in the cardiac lumen. In this article, we present the case of a 72-year-old female with a significant history of cardiovascular disease, admitted to our clinic because of rest dyspnea, fatigue, and minimal chest pain. The 12-lead electrocardiogram showed a trifascicular block (a second-degree atrioventricular block Mobitz II, associated with a right bundle branch block and left anterior fascicle block) and negative T waves in DII, DIII, aVF, V4–V6 leads. An invasive coronary angiography was performed, which revealed no significant atherosclerotic lesions. However, a persistent capillary blush was present at the apex site of the left ventricular chamber, draining from the distal segments of both the anterior descending coronary artery and the posterior interventricular coronary artery. The intramural vascular network generating a left ventricle angiogram image of this kind was suggestive for persistent Thebesian vessels connecting the two coronaries with the left ventricular chamber.

Multiple Coronary Chamber Microfistulas or Persistent Thebesian Vessels?

Center of Advanced Research in Multimodality Cardiac Imaging, Cardio Med Medical Center

Journal of Interdisciplinary Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

{"article-title":"Multiple Coronary Chamber Microfistulas or Persistent Thebesian Vessels?"}

Coronary fistulas are rare, not gender-specific congenital conditions, consisting of communications between the coronary arteries and either another coronary...

Multiple Coronary Chamber Microfistulas or Persistent Thebesian Vessels?

Published Online: Nov 07, 2017

Page range: 262 - 265

Received: Jun 12, 2017

Accepted: Jul 26, 2017

DOI: https://doi.org/10.1515/jim-2017-0061

Keywords
coronary-cameral fistula, Thebesian vessels, congenital fistula

© 2017 Daniel Cernica et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Multiple Coronary Chamber Microfistulas or Persistent Thebesian Vessels?

Published Online: Nov 07, 2017

Page range: 262 - 265

Received: Jun 12, 2017

Accepted: Jul 26, 2017

DOI: https://doi.org/10.1515/jim-2017-0061

Keywordscoronary-cameral fistula, Thebesian vessels, congenital fistula

© 2017 Daniel Cernica et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
coronary-cameral fistula, Thebesian vessels, congenital fistula