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# Posterior vein of the left ventricle

The posterior vein of the left ventricle drains the underside of the [left ventricle](https://durgical.com/en/anatomy/left-ventricle/) into the coronary sinus at the back of the heart.

Official name: Inferior vein of left ventricle

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## What it is

A vein on the diaphragmatic (under) surface of the left ventricle, running up to the coronary sinus.

## What it does

Drains the inferior wall of the left ventricle.

## Key points

- Posterolateral veins such as this one are preferred targets for the left ventricular lead in resynchronization, because in left bundle branch block the posterolateral wall contracts last
- Its size and the number of posterolateral veins vary widely, so a venogram decides which vein can take the lead

## Key facts

**Drains**
Inferior (diaphragmatic) wall of the left ventricle, between the middle cardiac vein and the left marginal vein

**Into**
Coronary sinus (sometimes the [great cardiac vein](https://durgical.com/en/anatomy/great-cardiac-vein/))

## Relations

**Above**
[Coronary sinus](https://durgical.com/en/anatomy/coronary-sinus/) in the posterior coronary groove, which it joins

**Below**
Diaphragmatic surface of the heart, resting on the central tendon of the [diaphragm](https://durgical.com/en/anatomy/diaphragm/)

**Medial**
[Middle cardiac vein](https://durgical.com/en/anatomy/middle-cardiac-vein/) in the posterior interventricular groove

**Lateral**
Left marginal vein along the obtuse margin

## How to find it

Seen on the diaphragmatic surface of the left ventricle when the heart is lifted, climbing to the coronary sinus between the middle cardiac vein and the left marginal vein. At device implantation it is found on a balloon-occlusion venogram of the coronary sinus.

## On imaging

Coronary sinus venography, taken with a balloon catheter just before lead placement, or CT venography shows its size, angle of entry and course over the inferior wall of the left ventricle.

## Common problems

- Rarely a problem on its own.

## Clinical notes

- When no suitable vein is found or the lead cannot be placed through the coronary sinus, the left ventricular lead may be placed surgically on the outer surface of the heart
- A lead in a posterolateral vein can stimulate the nearby left [phrenic nerve](https://durgical.com/en/anatomy/phrenic-nerve/) and cause diaphragm twitching or hiccups; pacing is tested at high output during implantation to detect it

## Test yourself

Think of the answer, then tap the question to see it.

## Which wall of the heart does the posterior vein of the left ventricle drain?

The inferior (diaphragmatic) wall of the left ventricle, between the middle cardiac vein and the left marginal vein.

## Why are posterolateral veins such as the posterior vein of the left ventricle preferred for the left ventricular lead in resynchronization?

In left bundle branch block the posterolateral wall contracts last.

## How is a suitable vein for the left ventricular lead chosen?

By coronary sinus venography or CT venography, because the size and number of posterolateral veins vary widely.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
vena inferior ventriculi sinistri TA2 4162

**Official Spanish (DeCS)**
Vena posterior del ventrículo izquierdo

**English (TA2)**
Inferior vein of left ventricle

**Also called**
posterior vein of left ventricle · vena dorsalis ventriculi sinistri · venae ventriculi sinistri posteriores

## Related

- [Left ventricle](https://durgical.com/en/anatomy/left-ventricle/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Thorax, Heart Veins](https://www.ncbi.nlm.nih.gov/books/NBK549786/); [Anatomy, Thorax, Coronary Sinus](https://www.ncbi.nlm.nih.gov/books/NBK557566/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/inferior-vein-of-left-ventricle/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/inferior-vein-of-left-ventricle/