Vieussens’ arterial ring: a heart’s lifesaving jewellery

Abstract

Introduction. In 1706, Raymond de Vieussens described a proximal inter-coronary pathway connecting the conus branch of the right coronary artery (RCA) with an infundibular branch of the left anterior descending artery (LAD) or directly with the proximal LAD. Later, in the 19th century, this anatomical structure would be named in his honour “Vieussens’ arterial ring” (VAR). VAR serves as a collateral pathway in case of coronary artery disease. Case presentation. We present the case of a 58-year-old male with a concurrent ostial chronic total occlusion of the LAD and an acute thrombotic occlusion of the proximal RCA, that survived via a Vieussens’ arterial ring. Conclusions. The existence of collateral circulation holds a crucial role in the manifested symptoms and the prognosis of patients with ischaemic heart disease. The connection between the conus branch and the LAD (VAR) may provide adequate circulation to either the left or right coronary arterial system, preserving the left ventricular ejection fraction and allowing patients to survive even the most severe myocardial infarctions.

Keywords

• collateral circulation
• conus artery
• vieussens’ ring