Vieussens’ Arterial Ring Attenuates the Consequences of an Otherwise Large Anterior Myocardial Infarction

A 55-year-old patient, with a history of a recent ST-elevation myocardial infarction (STEMI) diagnosed elsewhere but not treated due to patient’s refusal, was urgently admitted to our hospital with symptoms of post-infarction angina over the last 48 hours. The patient, who remained hemodynamically stable, underwent urgent coronary angiography via a transradial access. Total occlusion of the left anterior descending (LAD) coronary artery was visualized right after the first diagonal branch, while the periphery of the LAD was opacified through collaterals from the proximal right coronary artery (RCA), an anatomic variation also knows as the Vieussens’ ring. Decision was taken not to proceed with revascularization, until viability in the territory of the LAD could be documented. Rhythmos 2016;11(4):98-99.