Related Experiment Video
Updated: Sep 14, 2025

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Incidental Finding of Vieussens' Collateral in Tricuspid Regurgitation Due to Infective Endocarditis
Swatam Jain1, Farzad Majidi2, Tharindra Pathiranage1
1Department of Internal Medicine, HCA Healthcare, MountainView Hospital, Las Vegas, Nevada, USA.
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.
More Related Videos
07:41Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
08:42Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Related Concept Videos
Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis I: Introduction
Mitral Regurgitation I: Introduction
Mitral Regurgitation II: Clinical Features and Diagnostic Tests
Endocarditis III: Medical Management
Endocarditis IV: Nursing Management