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Right inferior pulmonary vein

The right inferior pulmonary vein (RIPV) is one of the four main pulmonary veins that return oxygenated blood from the lungs to the left atrium. It drains the right lower lobe of the lung, collecting blood from segmental tributaries including the superior (apical, posterior, anterior) and basal segments.

The vein courses from the hilum of the right lung, inferior to the right superior pulmonary vein, and enters the posterior aspect of the left atrium at its inferolateral wall. The pulmonary venous ostia are clinically important in atrial fibrillation, as myocardial sleeves extending into the veins act as arrhythmogenic foci.

The right inferior pulmonary vein demonstrates anatomical variations, including common ostia with the right superior pulmonary vein or accessory pulmonary veins. Its identification is critical in electrophysiology, cardiac ablation therapy, pulmonary surgery, and cardiac imaging.

Synonyms

  • RIPV

  • Right lower pulmonary vein

  • Vena pulmonalis dextra inferior

Function

  • Returns oxygenated blood from the right lower lobe of the lung to the left atrium

  • Contributes to systemic arterial oxygenation

  • Serves as an electrophysiological landmark in atrial fibrillation ablation procedures

  • Provides a key imaging landmark in cardiac CT and MRI

Tributaries

  • Superior segmental vein of right lower lobe

  • Basal segmental veins (anterior, lateral, posterior, medial)

MRI Appearance

T1-weighted images:

  • RIPV appears as a signal void (black lumen) due to venous flow

  • Vessel wall hypointense; surrounding atrial and pericardial fat hyperintense

T2-weighted images:

  • Lumen also appears as a signal void

  • Thrombosis within the vein appears as intermediate to high signal

T2 TRUFISP (cardiac-gated):

  • RIPV lumen appears as a bright, sharply defined vascular channel

  • Allows dynamic visualization of venous filling into the left atrium

  • Excellent for detecting flow disturbances, stenosis, or compression

STIR (Short Tau Inversion Recovery):

  • Fat suppression increases conspicuity against mediastinal fat

  • Perivascular edema, fibrosis, or post-ablation inflammation appears hyperintense

T1 Post-Contrast (Gadolinium-enhanced MRI):

  • RIPV enhances homogeneously with contrast

  • Filling defects indicate thrombosis or post-ablation stenosis

  • Useful for mapping venous ostia before electrophysiological procedures

MRI Non-Contrast 3D Cardiac-Gated Imaging (Whole-heart):

  • Depicts the RIPV as a continuous venous channel draining into the left atrium

  • Provides high-resolution 3D reconstructions of pulmonary venous anatomy

  • Valuable in atrial fibrillation ablation planning, congenital anomaly detection, and when contrast is contraindicated

CT Appearance

CT Coronary Angiography (CCTA):

  • RIPV visualized as an enhancing vessel draining into the posterior left atrium

  • Clearly demonstrates ostium size, course, and anatomical variations

  • Detects post-ablation pulmonary vein stenosis, thrombosis, or anomalous pulmonary venous return

  • Multiplanar and 3D reconstructions provide precise mapping for surgical and electrophysiological interventions

MRI images

Right inferior pulmonary vein anatomy MRI coronal image -img-00000-00000

MRI images

Right inferior pulmonary vein mri image

CT image

Right inferior pulmonary vein anatomy CT axial image -img-00000-00000