Incidental Finding of Vieussens' Collateral in Tricuspid Regurgitation Due to Infective Endocarditis

Division

Far West

Hospital

MountainView Hospital

Document Type

Case Report

Publication Date

7-16-2025

Keywords

coronary artery bypass, endocarditis, percutaneous coronary intervention, tricuspid valve

Disciplines

Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences

Abstract

BACKGROUND: This is an exceedingly rare case of an incidental finding of Vieussens' collateral with severe tricuspid regurgitation due to infective endocarditis.

CASE SUMMARY: A 46-year-old male presented with dizziness, and a workup revealed infective endocarditis of the tricuspid valve with severe tricuspid regurgitation. Coronary angiography revealed a chronic total occlusion of the ostial right coronary artery (RCA), with well-developed collaterals from the left anterior descending artery to the RCA. The patient underwent tricuspid valve replacement and single-vessel coronary artery bypass grafting to the RCA.

DISCUSSION: This case demonstrates the importance of identifying Vieussens' collateral and assessing the need for bypass surgery based on the clinical presentation, particularly if the patient experiences a future myocardial infarction and percutaneous coronary intervention becomes challenging.

TAKE-HOME MESSAGES: Understanding Vieussens' collateral anatomy and clinical presentation are key to assessing future MI risk. Due to intervention challenges, coronary artery bypass grafting may be needed to protect against future ischemic events.

Publisher or Conference

JACC Case Reports

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