On 2014 Jan 11, Brett Snodgrass commented:

Dear Authors,

Thank you for the refreshing article that prudently identifies the Thebesian veins as veins, structures distinct from both the arteriosinusoidal (vessels-arteries) and the arterioluminal (vessels-arteries).

Please consider the excerpt:

"Arteriosinusoidal vessels connect arterioles to the chambers and Thebesian veins connect capillaries to the chambers. Beside these two vessel types, few small arterioluminal arteries drain directly into the chambers*

The definition of Thebesian veins connecting to the chambers may be correct, but might be more descriptively stated as by Pratt as they also include connections larger than capillaries. It is possible that the Thebesian veins do not always directly connect the venular end of a capillary bed to the heart chamber, but may occasionally connect a small vein to the heart chamber.

http://bit.ly/ThebesianByPratt

Please consider that both the arterioluminal and arteriosinusoidal vessels (vessels of Wearn) drain to the heart chambers from the coronary arteries.

The arteriosinusoidal vessels connect {small arteries &/or arterioles} to [myocardial sinusoids] which connect to the (heart chambers).

The arterioluminal vessels connect {small arteries &/or arterioles} to (heart chambers). http://bit.ly/JTWearn Wearn examined the celloidin casts of the arterioluminal vessels and noted that they exhibit vessel diameters that range from 0.2 mm to 1.0 mm. The diameter of the lumina as measured in the collapsed state ranged from 0.04 to 0.2 mm. (http://bit.ly/JTWearn page 158).

Wearn was probably too humble to name the vessels after himself. However, he referred to both the arteriosinusoidal & arterioluminal vessels collectively as "arterioluminal." An analogy for this difficult nosology is appreciated by consideration the drum and drumset termed "Tabla." A wise professor once told of a drumset where both drums were collectively called “Tabla,” and the drum on the right was also called “Tabla.”

In this analogy, the term “Tabla” is comparable to the term “arteriosinusoidal vessel.”

In summary, using the same word to represent two different concepts or two different things can probably be confusing. When uncertain of the specific type of arterial-vessel as defined by Wearn, the term “vessels of Wearn” may be appropriate. The eponym vessels of Wearn is the only specific noun that has been appropriately applied to these connections.

The vessels of Wearn connect coronary arteries to each of the four heart chambers. The term "ventriculocoronary connection,"(VCC) is certainly appropriate when referring to isolated ventricular connections. However, using the term VCC could also be applied to traumatically induced fistulae and therefore it does not reflect the normal nature of these connections. Thus the noun "vessels of Wearn," is appropriate in a manner similar to the term "distal convuluted tubule" is appropriate for those specific tubules. Thus, an eponym vessels of Wearn may be appropriate for these normal connections between the coronary arteries and heart chambers.

Thank you again for the excellent article.

Comments and suggestions are kindly requested. My aim is to follow the plea of Dr. Lurie and work with others to help produce accurate cardiac nomenclature.

Thank you very much.

On 2014 Jan 11, Brett Snodgrass commented:

Dear Authors,

Thank you for the refreshing article that prudently identifies the Thebesian veins as veins, structures distinct from both the arteriosinusoidal (vessels-arteries) and the arterioluminal (vessels-arteries).

Please consider the excerpt:

"Arteriosinusoidal vessels connect arterioles to the chambers and Thebesian veins connect capillaries to the chambers. Beside these two vessel types, few small arterioluminal arteries drain directly into the chambers*

The definition of Thebesian veins connecting to the chambers may be correct, but might be more descriptively stated as by Pratt as they also include connections larger than capillaries. It is possible that the Thebesian veins do not always directly connect the venular end of a capillary bed to the heart chamber, but may occasionally connect a small vein to the heart chamber.

http://bit.ly/ThebesianByPratt

Please consider that both the arterioluminal and arteriosinusoidal vessels (vessels of Wearn) drain to the heart chambers from the coronary arteries.

The arteriosinusoidal vessels connect {small arteries &/or arterioles} to [myocardial sinusoids] which connect to the (heart chambers).

The arterioluminal vessels connect {small arteries &/or arterioles} to (heart chambers). http://bit.ly/JTWearn Wearn examined the celloidin casts of the arterioluminal vessels and noted that they exhibit vessel diameters that range from 0.2 mm to 1.0 mm. The diameter of the lumina as measured in the collapsed state ranged from 0.04 to 0.2 mm. (http://bit.ly/JTWearn page 158).

Wearn was probably too humble to name the vessels after himself. However, he referred to both the arteriosinusoidal & arterioluminal vessels collectively as "arterioluminal." An analogy for this difficult nosology is appreciated by consideration the drum and drumset termed "Tabla." A wise professor once told of a drumset where both drums were collectively called “Tabla,” and the drum on the right was also called “Tabla.”

In this analogy, the term “Tabla” is comparable to the term “arteriosinusoidal vessel.”

In summary, using the same word to represent two different concepts or two different things can probably be confusing. When uncertain of the specific type of arterial-vessel as defined by Wearn, the term “vessels of Wearn” may be appropriate. The eponym vessels of Wearn is the only specific noun that has been appropriately applied to these connections.

The vessels of Wearn connect coronary arteries to each of the four heart chambers. The term "ventriculocoronary connection,"(VCC) is certainly appropriate when referring to isolated ventricular connections. However, using the term VCC could also be applied to traumatically induced fistulae and therefore it does not reflect the normal nature of these connections. Thus the noun "vessels of Wearn," is appropriate in a manner similar to the term "distal convuluted tubule" is appropriate for those specific tubules. Thus, an eponym vessels of Wearn may be appropriate for these normal connections between the coronary arteries and heart chambers.

Thank you again for the excellent article.

Comments and suggestions are kindly requested. My aim is to follow the plea of Dr. Lurie and work with others to help produce accurate cardiac nomenclature.

Thank you very much.