Incidental Cannulation of Left Ventricular Thebesian Vein

A 52-year-old woman presented with chest pain from spontaneous coronary artery dissection of the distal segment of the first diagonal branch of the left anterior descending coronary artery. We performed left ventriculography, injecting 20 mL of contrast medium at 10 mL/s through a 5F, 100-cm Performa^® Ultimate 1 diagnostic cardiac catheter with bumper tip and wire-braid design (Merit Medical Systems, Inc.). The opacified left ventricle (LV) showed mild anterolateral hypokinesis (estimated LV ejection fraction, 0.50). The catheter moved during the procedure, inadvertently cannulating a Thebesian vein with contrast injection (Fig. 1). The dye cleared in 30 seconds. The patient was discharged from the hospital the next day, in stable condition.