Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Veins: Head, Neck, and Thorax

Pulmonary Veins

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed

Parsons, et al., reported 35 cases of anomalous pulmonary drainage without cardiac anomalies. In five cases, the pulmonary vein was connected to the superior vena cava, in five to the right auricle, in five to the left innominate (brachiocephalic) vein, in nine to the coronary sinus, in one to the inferior vena cava, in three to the portal vein, in five to a persistent left superior vena cava, and two to the ductus venosus. The pulmonary veins may also open into the azygos vein.

Pulmonary veins vary in number and size. There are reports of one or more pulmonary veins entering either the right atrium or the inferior or superior vena cava or azygos vein. In one case, a left pulmonary vein opened into the left brachiocephalic vein.

These unusual connections between the pulmonary veins and neighboring, many adversely inappropriate, veins are explicable only on the basis of very early embryonic stages in which the developing foregut, trachea, and lung buds are supplied by a common plexus of small channels that network in all directions through the loose mesenchyme and communicate with the primitive cardinal veins in many places. With the development of certain channels in this primitive vascular bed to form the pulmonary veins leading to the left atrium, the primitive connections with the cardinal veins usually disappear. The unusual development of one or more of them, and its retention by the adult derivative of the particular part of the cardinal system involved, are most probably responsible for the occurrence of these unusual pulmonary connections.

Steinberg and Finby classified the congenital anomalies of the pulmonary circulation as follows

From Steinberg, I. and N. Finby, 1956. See complete reference below.

Keith, et al. reported on 58 cases of anomalous pulmonary drainage as follows;

Anomalous drainage of the pulmonary veins occurs in about 0.7% of individuals (Specht and Brown).

References

Alfke, H., Wagner H.-J. and K.-J. Klose. (1995) A case of an anomalous pulmonary vein of the right middle lobe. Cardiovasc. Intervent. Radiol. 18(6):406-409.

Anson, B.J., Ed. (1966) Morris' Human Anatomy, The Blakiston Division, McGraw-Hill Book Company, New York.

Appelton, A.B. (1945) The arteries and veins of the lungs. 1. Right upper lobe. J. Anat. 79:97-120.

Aüer, J. (1948) The development of the human pulmonary vein and its major variations. Anat. Rec. 101:581-594.

Bergman, R.A., Thompson, S.A., Afifi, A.K. and F.A. Saadeh. (1988) Compendium of Human Anatomic Variation: Catalog, Atlas and World Literature. Urban & Schwarzenberg, Baltimore and Munich.

Boyden, E.A. (1946) The anatomical hazards of lingulectomy. Surgery 20:828-829.

Boyden, E.A. (1961) The nomenclature of the bronchopulmonary segments and their blood supply. Diseases Chest 39:1-6.

Boyden, E.A. and J.G. Scannell (1948) An analysis of variations in the bronchovascular pattern of the right upper lobe of 50 lungs. Am. J. Anat. 82:27-73.

Boyden, E.A. and C.J. Hamre. (1951) An analysis of variations in the broncho-vascular patterns of the middle lobe in fifty dissected and twenty injected lungs. J. Thoracic. Surg. 21:172-188.

Brantigan, O.C. (1947) Anomalies of the pulmonary veins. Their surgical significance. Surg., Gynecol. Obstet. 84:653-658.

Brody, H. (1942) Drainage of the pulmonary veins into the right side of the heart. Arch. Pathol. 33:221-240.

Butler, H. (1952) Abnormal disposition of the pulmonary veins. J. Anat. 86:485-486.

Butler, H. (1952) An abnormal disposition of the pulmonary veins. Thorax 7:249-254

Compere, D.E. and H.F. Forsyth. (1944) Anomalous pulmonary veins. J. Thoracic.Surg. 13:63-66.

Chiari, H. (1880) Einmündung der rechtsseitigen Pulmonalvenen in der rechten Vorhof. Defect im septum atriorum. Excentrische Hypertophie der rechten Herzhälfte. Dilitation der arteria pulmonalis. Bei einem 2jährigen Knaben. Jahrbuch für Kinderheilkunde und Physische Erziehung. 15:319-334.

Conn, L.C., Calder, J., MacGregor, J.W. and R.F. Shaner. (1942) Report of a case in which all the pulmonary veins from both lungs drain into the superior vena cava. Anat. Rec. 83:335-340.

Cooke, F.N., Evans, J.M., Kistin, A.D. and B. Blades. (1951) An anomaly of the pulmonary veins. J. Thoracic Surg. 21:452-459.

Cordier, G. et C. Cabol. (1953) Les veines du poumon gauche. Caractères généraux et systématisation. Assoc. Anatomistes, Comptes Rendus. 40:627-638.

Cords, E. (1921) Ein Fall von teilweiser Erhaltung der V. cava sup. sin. zusammen mit einer Anomalie der Vv. pulmonales. Anat. Anz. 54:491-495.

Delmas, A. et A. Heffez (1952) Sur l'abouchement des veines pulmonaires dans l'oreillette gauche (nombre et calibre). Assoc. Anatomistes, Comptes Rendus. 39:777-783.

Dotter, C.T., Hardesty, N.M. and I Steinberg. (1949) Anomalous right pulmonary vein entering the inferior vena cava: Two cases diagnosed during life by angiocardiography and cardiac catheterization. Am. J. of the Medical Sciences. 218:31-36.

Douglass, R. (1948) Anomalous pulmonary vessels. J. Thoracic Surg. 17:712-716.

Edwards, J.E. (1953) Pathologic and developmental considerations in anomalous pulmonary venous connection. Staff Meetings of the Mayo Clinic 28(17):441-452.

Edwards, J.E. and J.W. DuShane (1950) Thoracic venous anomalies. Arch. Path. 49:517-537.

Edwards, J.E., DuShane, J.W., Alcott, D.L. and H.B. Burchell. (1951) Thoracic venous anomalies. Arch. Path. 51:446-460.

Findlay, Jr.,C.W. and H.C. Maier (1966) Anomalies of the pulmonary vessels and their surgical significance. Surgery 29:604-641.

Gegenbaur, C. (1880) Ein Fall von Einmündung der oberen rechten Lungenvene in die obere Hohlvene. Morphologisches Jahrbuch 6:315-317.

Ghon, A. (1916) Ein Beitrag zu den Anomalien der Pulmonalvenen. Beiträge Pathol. Anat. Allg. Pathol. 62:175-193.

Grishman, A., Poppel, M.H., Simpson, R.S. and M.L. Sussman. (1949) The roentgenographic and angiographic aspects of (1) aberrant insertion of pulmonary veins associated with interatrial defect and (2) congenital arteriovenous aneurysm of the lung. Am. J. Roentgenol. 62:500-508.

Grishman, A., Brahms, S.A., Gordon, A. and F.H. King. (1951) Aberrant insertion of the pulmonic veins. J. Mount Sinai Hospital 17:336-343.

Gruber, W. (1876) Ein Fall von Einmundung der Vena pulmonalis dextra superior in die Vena cava superior. Arch. Pathol. Anat. Physiol. Klin. Med. 68:284.

Gruber, W. (1885) Einmündung der Vena pulmonalis dextra superior in die Vena cava superior. Arch. Pathol. Anat. Physiol. Klin. Med. 102:3-5.

Harris, H.A. and I. Lewis. (1940) Anomalies of the lungs, with special reference to the dangers of abnormal vessels in lobectomy. J. Thoracic Surg. 9:667-671.

Healey, Jr., J.E. (1952) An anatomic survey of anomalous pulmonary veins: Their clinical significance. J. Thoracic Surg. 23:433-444.

Hickman, -. (1869) Malformation of the heart.; 1) Transposition of auricles and of the aorta; absence of pulmonary artery; patent foramen ovale; communicating ventricles; with lateral transposition of principal viscera; cyanosis. 2) Transposition of viscera. Malformation of heart; pulmonary veins from right lung entering left auricle and from left lung entering right auricle. Trans. Pathol. Soc. Lond. 20:88-92, 92-98.

Hughes, C.W. and P.C. Rumore. (1944) Anomalous pulmonary veins. Arch. Pathol. 37:364-366.

Ingalls, N.W. (1932) Anomalous pulmonary vessels. Anat. Rec. 53:269-281.

Johnston, T.B. (1915) A rare vascular anomaly- opening of the upper left pulmonary vein into a persistent left superior vena cava. J. Anat. Physiol. 69:182-186.

Keith, J.D., Rowe, R.D., Vlad, P. and J.H. O'Hanley. (1954) Complete anomalous pulmonary venous drainage. Am. J. Medicine 16:23-38.

Kolesnikow, N. (1932) Ein seltener Fall der Mündung der Vena pulmonalis in die Vena cava superior. Anat. Anz. 74:233-237.

Lachi, P. (1879) Di alcune varietà anatomiche. L'Imparziale 19 (N. 14):365-372.

Lacroix, C. (1844) Cas remarquable d'anatomie anormale. J. de la Soc. de Médecine-Pratique de Montpellier. 7:199-216.

Looten, J. et G. Ruyssen. (1910) Anomalie de la veine pulmonaire. Bibliographie Anatomique 20:219-223.

McManus, J.F.A. (1941) A case in which both pulmonary veins emptied into a persistent left superior vena cava. The Canadian Medical Association Journal 46:261-264.

Nabarro, D. (1903) Two hearts showing peculiarities of the great veins. J. Anat. Physiol. 37:382-391.

Neil, C.A. (1956)Development of the pulmonary veins with reference to the embryology of anomalies of pulmonary venous return. Pediatrics 18:880-887.

O'Malley, T.S. (1917) An anomalous vena pulmonalis within the lung. Anat. Rec. 12:173-175.

Parsons, H.G., Purdy, A. and B. Jessup. (1952) Anomalies of the pulmonary veins and their surgical significance. Pediatrics 9:152-166.

Poynter, C.W.M. (1922) Congenital anomalies of the arteries and veins of the human body with bibliography. The University Studies of the University of Nebraska 22:1-106.

Schröder, R. (1911) über Anomalien der Pulmonalvenen, zugleich ein Beitrag zum Cor biloculare. Arch. Pathol. Anat. Physiol. 205:122-138.

Severeano, G. (1904) Réunion des veines pulmonaires droites dans un seul tronc. Bibliographie Anatomique 13:237-241.

Specht, H.D. and A.F. Brown. (1953) Drainage of pulmonary veins into ductus venosus with other anomalies. A.M.A. Arch. of Internal Medicine 92:148-151.

Steinberg, I. and A. Finby. (1956) Clinical and angiocardiographic features of congenital anomalies of the pulmonary circulation: A classification and review. Angiology 7:378-395.

Troyer, J.R. (1961) A multiple anomaly of the human heart and great veins. Anat. Rec. 139:509-513.

Van Cleave, C.D. (1931) A multiple anomaly of the great veins and interatrial septum in a human heart. Anat. Rec. 50:45-51.

Villemin, G., Dufour, R., Rigaud, A. et A. Gouaze. (1952) Le systéme veineux pulmonaire dans les types morphologiques. Assoc. Anatomistes, Comptes Rendus. 39:174-177.

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