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02 True Thebesian Veins

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    May 25, 2014 5:16:26 PM PDT

    Thebesian Vein Definition 

    Thebesian vein: vessels that “open from the ventricle and auricles into a system of fine branches that communicate with the coronary arteries and veins by means of capillaries, and with a coronary vein —but not with a coronary artery, by vessels larger than capillaries."

    thebesian venous drainage

    Thebesian veins, also known as ''vasa Thebesii'', ''vessels of Thebesius'', and ''venae cardiacae minimae'' are "veins", that are defined by their proximal and distal connections, and not prinicipally by their size.

    The medical literature is often incorrect in using the word "Thebesian veins," and therefore, several articles have been selected to highlight appropriate use of the term. True Thebesian veins were originally reported by Adam Christianus Thebesius, and his seminal work on the matter is published below.

    Thebesian veins were also described by Pratt whose work is also several posts below

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    DEFINITION. 

    "Thebesian veins" are vessels that connect the heart chambers to the coronary veins.

    Thicker myocardium tends to present more difficulty for fluid to work its way through the myocardial vessels, and that is probably why they are appreciated less frequently, and are truly less prevalent in the ventricles than in the atria.  

    Other terms that refer to the Thebesian vessels

    Thebesian venous lake

    1. Thebesian veins

    2. Deep cardiac veins

    3. Smallest cardiac veins

    4. Venae cordis minimae

    5. Venae cardiacae minimae

    6. veins of Thebesius

    7. vessels of Thebesius

    8. Thebesian vessels

    9. vasa Thebesii

    10. Coronary thebesian system

    11. Smallest Cardiac veins

    12. Thebesian circulation

    The following definitions are from Academic dot ru

    • Thebesian — Thebesian, a. Anat. (θiːˈbiːsɪən) [f. Thebesius, name of a German anatomist (1686–1732) + an.] Applied to structures in the heart discovered or investigated by Thebesius: Thebesian foramina, small openings into the right auricle, believed to be… …   Useful english dictionary

    • thebesian circulation — the circulation of blood through the venae cordis minimae (thebesian veins) …   Medical dictionary

    • Thebesian vein — The·be·sian vein thə bē zhən n any of the minute veins of the heart wall that drain directly into the cavity of the heart called also Thebesian vessel The·be·si·us te bā zē əs Adam Christian (1686 1732) German anatomist. Thebesius was the first… …   Medical dictionary

    • thebesian vessel — noun also thebesian vein or thebesian channel thə̇ˈbēzhən Usage: sometimes capitalized T Etymology: from Adam C. Thebesius died 1732 German anatomist + English an : any of the minute veins of the heart wall that drain directly int …   Useful english dictionary

    • Adam Christian Thebesius — (January 12, 1686 November 10, 1732) was a German anatomist who was a native of Sandenwalde, Silesia. He studied medicine in Jena, Leipzig and Leiden, and received his doctorate from the University of Leiden in 1708. In 1709 Thebesius started a… …   Wikipedia

    • Vein — A blood vessel that carries blood low in oxygen content from the body back to the heart. The deoxygenated form of hemoglobin (deoxyhemoglobin) in venous blood makes it appear dark. Veins are part of the afferent wing of the circulatory system… …   Medical dictionary

    • Venae cordis minimae — (also called smallest cardiac veins, venae cardiacae minimae , or Thebesian veins) are minute valveless veins in the walls of all four heart chambers. They are most abundant in the right atrium and least in the left ventricle. They originate… …   Wikipedia

    • Thebesius — Adam C., German physician, 1686–1732. See thebesian foramina, under foramen, thebesian valve, thebesian veins, under vein …   Medical dictionary

    • venae cardiacae minimae — [TA] smallest cardiac veins: numerous small veins arising in the muscular walls and draining independently into the cavities of the heart, particularly the right atrium and ventricle; called also thebesian veins and venae cordis minimae [TA… …   Medical dictionary

    • Hypoxia (medical) — Hypoxia ICD 9 799.02 MeSH D000860 Hypoxia, or hypoxiation, is a pathological condition in which the body as a whole (generalized hypoxia) or a region of the body (tissue hypoxia) is deprived of adequate ox …   Wikipedia

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    Proper use of the term was published in 2014 by Gach et al.

     

    Thebesian Veins on Left Ventriculography

    http://bit.ly/ThebesianVeinVideo

    Unintentional "Ventriculo-Phlebo-Myopericardiography." 

    Google+

    There is a daunting number of peer-reviewed published studies that use ambiguous, inaccurate, and misleading nomenclature to report connections between the heart chambers and coronary vessels. The Thebesian veins, non-eponymously referred to as the “venae cardiacae minimae,” connect the coronary veins to the heart chambers.1 The vessels of Wearn, non-eponymously referred to as the “arteriae cardiacae minimae,” connect coronary arteries to the heart chambers.1-3 Thebesian veins and its synonyms including the “vessels of Thebesius,” should strictly be used to refer to connections between coronary veins and the heart chambers. Approximately 37-years after Wearn’s famous Harvey lecture detailing the difference between Thebesian veins and what he referred to as “arterioluminal” vessels, the term “Thebesian veins,” were used in the medical literature to describe the areterioluminal vessels.4,5 Wearn chose the term vessels to describe the arteries because the arteries lose their arterial histologic characteristics as they approach the heart chamber. The arteries lose their well-delineated and continuous internal elastic laminae and muscular media as they approach the heart chamber.6 Wearn was astutely aware of the difference between arteries and veins. Dr. Wearn created macroscopic casting of the thebesian veins in heart number 11.6 In addition, Wearn performed macroscopic casting of the arterial-cameral (arterioluminal, vessels of Wearn, arteriae cardiacae minimae) connections and defined two vessel types based on the histologic appearance. These were the arterioluminal and the arteriosinusoidal vessels.6 The term arterioluminal is less preferable than the eponym “vessels of Wearn,” because the term arterioluminal refers to two different specific entities.6 This may be a reason that Wearn’s 1940 lecture that clearly defined the distinciton between Thebesian veins and the arterioluminal vessel and arteriosinusoidal vessels, (collectively the “vessels of Wearn,”) was not properly incorporated into the medical literature.5,7 The lack of precise terminology, followed by the incorrect publication suggesting that myocardial sinusoids were a phantom led some experts to suggest unfavorable theories for the pathogenesis of the coronary arteriopathy in pulmonary atresia with intact ventricular septum.7 The pathogenesis of the coronary arteriopathy was subsequently clarified and the relationship to the “vessels of Wearn,” illustrated.2 It seems prudent to clarify the misinformation in the medical literature as it relates to the coronary – cameral connections. Coronary may refer to arteries or veins, and caution should be used when reading the literature as the article may not specify whether the coronary vessel is an artery or a vein. For example, Angelini acknoweldges the distinction between the Thebesian veins and the connections that collectively form the “vessels of Wearn.”8 In contrast, other authors refer to the arterial connections as Thebesian.9 The Federation of International Anatomical Nomenclature (FIPAT) informed this author through personal correspondance that they do not use eponyms in the book Terminologia anatomica. They refer to the Thebesian veins as “venae cardiacae minimae.” Therefore the eponym “vessels of Wearn,” may be less suitable for international dissemination compared to the non-eponymous term “arteriae cardiacae minimae.” Echoing the voice of pediatric cardiologists I ask that cardiologists, clinician scientists, anatomists, and histologists collaborate to establish accurate anatomical nomenclature.1 Referring to arteries as Thebesian “veins,” may mislead some to think that the arteries are not arteriae cardiacae minimae, but instead venae cardiacae minimae. Great caution is urged as readers review the medical literature related to connections termed “Thebesian.”


    This post was edited by DrSocial Admin at April 7, 2015 4:35:35 PM PDT
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    May 27, 2014 11:23:25 PM PDT

    True Thebesian Vein: it connects from the heart chambers to the coronary veins & then the coronary sinus.

    In contrast, a vessel-of-Wearn would demonstrate contrast flow from the heart chamber to the coronary artery. The contrast may eventually return to the coronary sinus if it entered a vessel-of-Wearn, but the contrast would be dispered along many different paths from the coronary artery - smaller arteries- capillary bed - venular side of capillary bed - small veins - larger veins - coronary veins - coronary sinus. 

    Thebesian veins (venae cardiace minimae).

    vessels of Wearn (arteria cardiacae minimae) proposed.*

    Again, we determine that it is NOT a "vessel of Wearn" because it fills the coronary veins & coronary sinus. If it was a vessel-of-Wearn, it would fill the coronary artery, and then diffuse into the capillary bed.

    Inadvertent Thebesian Vein Cannulation During Radial Access Ventriculography 

    Christopher Judkins, MBBS; Eric Yamen, MBBS
    J Am Coll Cardiol Intv. 2013;6(2):e9-e10. doi:10.1016/j.jcin.2012.09.014
    09014_gr1.jpeg

    Thebesian Vein Cannulation during Left Ventriculography with an MPA-1 Catheter

    Still image during injection of contrast with filling of the thebesian veins (black arrows), coronary veins(thin white arrows), and coronary sinus (thick white arrow).

    Image not available.
     

     

    True Thebesian Veins


    This post was edited by DrSocial Admin at April 7, 2015 4:42:09 PM PDT
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    May 27, 2014 11:47:51 PM PDT

    This image represents one patient, one case, and two different publications, with the latter publication acknowledging the former. 

    Imaging of Thebesian Venous System — NEJM http://nej.md/18JgrD3  An excellent example of accurate use of the term "Thebesian."

    This article is also published in Radiology technology journal.

    Thebesian venous system

    http://www.ncbi.nlm.nih.gov/pubmed/19901354 Rare view of thebesian venous system. Smith TM. Author information PMID: 19901354 [PubMed - indexed for MEDLINE]

    -http://www.ncbi.nlm.nih.gov/pubmed/18703466 N Engl J Med. 2008 Aug 14;359(7):e8. doi: 10.1056/NEJMicm072885. Direct NEJM link here:

    http://www.nejm.org/doi/full/10.1056/NEJMicm072885

    Images in clinical medicine. Imaging of thebesian venous system. Singhal S1, Khoury S. Author information PMID: 18703466 [PubMed - indexed for MEDLINE] Free full text



    This post was edited by DrSocial Admin at April 7, 2015 4:44:17 PM PDT
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    May 27, 2014 11:48:20 PM PDT

     

    How to determine whether a vessel or communication is a "True" Thebesian vein and not an arter:

     

    1. Ask Author if certain it did not enter the subepicardial coronary

    2. review image to ensure it didn't (& be skilled, accurate, competent in this specific task)

    arteries, but "~only" the coronary sinus.

     

    Vessels of Thebesius. http://www.ncbi.nlm.nih.gov/pubmed/23428022  I mention this because ~50% of publications use "Thebesian" for VCACs (or ACACs) 

    atrio-coronary arterial communications


    This post was edited by Brett Snodgrass at May 28, 2014 1:03:52 AM PDT
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    May 28, 2014 1:02:42 AM PDT

    vessels of Thebesius are veins

    The vessels of Thebesius (Thebesian veins) described by Pratt.

    http://bit.ly/Thebesius  Pratt defines  vessels of Thebesius: coronary veins <=> heart chambers http://bit.ly/ThebesianByPratt


    This post was edited by DrSocial Admin at April 7, 2015 4:46:13 PM PDT
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    June 2, 2014 3:13:36 PM PDT
     Here is another example of "True Thebesian Veins"
     http://www.ncbi.nlm.nih.gov/pubmed/19968924

    This post was edited by Brett Snodgrass at November 13, 2014 10:12:02 PM PST
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    June 7, 2014 1:34:00 PM PDT

    This is an excellent diagram from Nordenstrom, B, 

    The Thebesian Circulation in Coronary Angiography

    Bjorn Nordenstrom

    Angiology 1965 16:616

    DOI: 10.1177/000331976501601007

    Thebesian veins myocardial sinusoids vasa Wearn

    Within the past two years Google Translate began translating Latin to the other languages. This means that once I configure the latin keyboard, the original works that transformed our understanding of human anatomy will be available in English, along with the original text in Latin. 


    This post was edited by DrSocial Admin at April 7, 2015 4:48:07 PM PDT
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    August 2, 2014 12:03:26 AM PDT

    You can support accurate anatomical nomencluatre by liking the "Thebesian veins," on Facebook and following the "Thebesian veins," on Google+ 

    1. https://www.facebook.com/Thebesianveins

    2. https://plus.google.com/109496355142888203263/posts

    ================================================================

    Below is the original publication by Thebesius, A.C. where he discovered the anatomical structures that have been referred to by the following synonymous names:

    smallest cardiac veins, venae cardiacae minimae, Thebesian veins, vessels of Thebesius, vasa Thebesii and others.


    This post was edited by DrSocial Admin at April 7, 2015 4:50:52 PM PDT
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    November 13, 2014 9:01:08 PM PST

    Original Publication by Adam Christianus Thebesius Starts Here. 21 images scanned including the cover.

     

     


    This post was edited by Brett Snodgrass at December 15, 2014 4:42:54 AM PST
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    Disputatio Medica Inauguralis de


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