Total Anomalous Pulmonary Venous Drainage with Unusual Features.

The occurrence of relatively soft continuous murmurs of the venous hum type in supradiaphragmatic forms of total anomalous pulmonary venous drainage is well recognized (Keith et al., 1954; Keith, Rowe, and Vlad, 1958). Loud continuous murmurs occur at times but are considerably less common (McKusick, 1958). This paper describes two cases of total anomalous pulmonary venous drainage in which loud continuous murmurs simulating those of patent ductus arteriosus were heard in the left infraclavicular region. These murmurs appear to have been caused by unusual anatomical variations in the anomalous vertical venous channels by which pulmonary venous blood drained to the superior vena cava.