We read the article by Kim et al., and are obliged to clarify certain terms used therein [1]. The term “arterioluminal vessel” was introduced by Wearn in 1933 and contained two definitions [2]. For clarity, Wearn subclassified the aformentioned vascular communications between coronary arteries and heart chambers into the arterioluminal and arteriosinusoidal vessels [2]. For disambiguation, the term “vessels of Wearn” has been used to encompass the arterioluminal and arteriosinusoidal vessels. The 1933 article by Wearn notes that it was 1706 when the coronary artery-cameral connections were first reported by Raymond Vieussens [2], [3]. The 1708 publication by Thebesius was about a study that discovered the coronary vein-cameral connections, which have been eponymously referred to as Thebesian veins [4].
It is fundamentally erroneous to classify an arterioluminal and/or arteriosinusoidal vessel as a Thebesian vein. However, careful review of the original report published in 1933 by Wearn, i.e., the report that introduced the terms arterioluminal and arteriosinusoidal, should provide the reader and future authors with a uniform nomenclature.
Also, many of the connections reported by Kim et al. may be of the arteriosinusoidal and not the arterioluminal subtype of the vessels of Wearn.
The arteriocapillary connections were inaccurately reported as a type of Thebesian vein by Kim et al., and the possibility of an arteriocapillary type of coronary artery-cameral connection may warrant further study [1]. Parenthetically, coronary arteries normally flow toward coronary capillaries. Capillaries could theoretically transmit flow into the cardiac lumen in a manner similar to the myocardial sinusoids [2]. Regardless, none of the three terms reported by Kim et al. as Thebesian veins are properly attributable to Thebesius [1].
The authors of this letter have been trying to correct the erroneous and misleading nomenclature that refers to the coronary artery-cameral connections “vessels of Wearn” as valveless Thebesian veins. Arteries and their tributaries are considered valveless. Thus, using the term “valveless Thebesian vein” to refer to a type of coronary artery-cameral connection facilitates obfuscation and not clarity. The word “valveless” is irrelevant, the word "Thebesius" incorrectly suggests that the artery-cameral connections were discovered by Thebesius, and the word "vein" misrepresents the nature of the vascular connection. We plead for authorship and advocacy by others to help create and establish medical terminology that is an accurate reflection of reality [5]. With the international use of consistent medical terminology, the natural history, prevalence, and prognosis should become more granular for both the Thebesian veins and the vessels of Wearn.
Conflict of interest
Each author reports no conflict of interest.
Contributor Information
Brett T. Snodgrass, Email: brettsnodgrass@hotmail.com.
Aruna Chilakala, Email: drchilakala@gmail.com.
References
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