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02 True Thebesian Veins

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    November 13, 2014 9:58:44 PM PST

    Page 18 of 21 of document.

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    November 13, 2014 10:00:33 PM PST

    Page 19 of 21 of Document

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    November 13, 2014 10:02:12 PM PST

    Page 20 of 21 of document.


    This post was edited by Brett Snodgrass at November 13, 2014 10:02:42 PM PST
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    November 13, 2014 10:03:54 PM PST

    Page 21 of 21 of document.

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    November 16, 2014 2:23:58 AM PST

    This is presently a work in progress.

     

     

     

    Id quod teftantur ii, qui ultimis annis elapfis in bac illave parte curatius indagentes pulcherrimos nature mechanifmos tum ex fitu & ftructura arteriarum, tumb abfentia valvularum in vents nobis expofuerunt.

     

    Quibus ut multo plura jungenda fuperfunt, itabus quoque collineant pauce bequas confscrpf periodi, explicantes rivulum Sanguinis ab oceano abeuntem & peractis in cordis Substantia muniis redeuntem; circulumnempe Sanguiuis, qui in ufus cordis proprios a natura adornatur.  Evit forfan & bic aliquid novi expofitum, quod tamen an a me ubique debite descriptum fit, judicent viri me peritiores, quorum judicia fi benigna accepero, audentior fiam, & que addere his pagellis hac vice nolui, alias eorum examini exhibebo.

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    December 16, 2014 5:05:07 PM PST

    Original Publication by Adam Christianus Thebesius 

    has ended.





    The next post is another example of patients with true Thebesian veins. 

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    • 1957 posts
    December 16, 2014 5:08:03 PM PST

    The term coronary-cameral connection should be described as either arterial, or as venular. Ideally, the word coronary might be similar to coronary-vein-to-cameras connection. In either case, these authors accurately report them as veins.

     
    comments and suggestions are welcome. 

    This post was edited by Brett Snodgrass at December 16, 2014 5:10:40 PM PST
    • Moderator
    • 1957 posts
    March 4, 2015 2:51:43 AM PST

    Giant Thebesian Vein,

    (At what point one refers to a Thebesian vein as 

    as fistula, may be variable, partially because we do not have precise cut-off values for what is abnormal, and we probably cannot always determine whether the vein-cameral (vein-heart chamber) connection is the enlargement of a normally present connection, or whether it developed over time followed by myocardial remodeling.eg,venogenesis (presumably similar to some forms of arteriogenesis, but on the other side of the capillary bed

     

    Great cardiac vein was found to drain to the right atrium.

     

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    • 1957 posts
    March 4, 2015 2:57:36 AM PST

    Left ventriculogram reveals a thebesian venous connection 


    We can tell it is Thebesian because the contrast that was injected from left ventricle into the myocardium is noted to drain from the endocardium-to_a-venous lake-to_the-coronary sinus.

     


    Where the contrast goes after it is injected is often critical in determining whether it is an arterial or venular connection.


    The Lake 

    (may be comparable to a lake of sinusoids and their common openings.) 

     

    A catheter was used to inject contrast into the thebesian vein. This was followed by prompt visualisation of cardiac veins and the coronary sinus. There was a large thebesian venous lake. 


    The timing and the how the contrast appears tells us about the vessels. For instance, this is clearly a vein, because the contrast went quickly to the cardiac vein and coronary sinus. Now, if it was to enter a vessel of Wearn, it may have had to drain through a capillary bed first. When the contrast medium goes through a capillary bed, it gets fussy because the dye goes everywhere the capillaries are. 


    In Summary, please consider performing literature reviews of Thebesian veins while remaining cognizant of 

    1. Where is the connection? (am I sure)

     

    2. How long does the dye or contrast medium take to get to the location (eg, from the endocardium-to_the-venous lake-to_the-coronary sinus)

     

    3. What does radiographic image of the contrast material look like? Does it remain well-delineated in the large vessels?

    Well Delineated 

     

    Ventriculogram

    This is a ventriculogram. The contrast dye goes everywhere, similar to how smoke from a cigarettes spreads out in many direection and becomes see-through (lurid, opalescent, semitransparent). 

    If the photo is hazy, then think it may be entering a capillary bed, or, as in this case, a large chamber such as the ventricle where it can diffuse in every direction.

     

     

    Heart 2005;91:1318 doi:10.1136/hrt.2004.058958

    Heart,

    Thebesian venous lake


    This post was edited by Brett Snodgrass at March 4, 2015 3:14:33 AM PST