Congenital Anomalies of the Heart 43 



Weiss-Eder (1909), Bellubekranz (1910) 2 cases, Mead (1910), Kingsley 

 (1911), Robertson (1911), Keith (1912) 2 cases, Pappenheimer (1913). 

 Heller & Gruber (1914), Milland (1914), Morse (1915)- Total 183 cases. 



§ XVI. 



XI. IRREGULARITIES OF THE VEINS ENTERING 

 THE HEART 



An exact study of the venous variations will appear later, but 

 since these anomalies are frequently encountered in connection 

 with congenital cardiac disease, I have included the following 

 references for those; who may be interested in such irregularities. 



A. Pulmonary Veins. — Of the pulmonary veins those on the 

 left more frequently unite to form a common trunk before en- 

 tering the atrium. This condition is probably brought about by 

 the absorption of the original single common trunk into the atrial 

 wall, so that each comes to open separately ; this is hardly 

 anomalous. 



The upper vein on the right may open into the superior vena 

 cava as in cases by Wilson (1798), Breschet (1826), Otto (1830), 

 Meckel (1820), Gruber (1876), and Ingalls (1907). 



According to Federow (1910) the pulmonary veins develop as 

 buds of the sinus venosus after the heart and other vessels have 

 been established; hence these may form irregular connections by 

 union with aberrant branches of vessels already developed. Brown 

 (1913) found an early vascular plexus, splanchnic plexus, in the 

 cat, which is carried down as the lung bud develops and early 

 connects with the sinus venosus and the post cava. By persist- 

 ence of the post caval tap he explains the case of Park (1912) 

 in which the right pulmonary vein pierces the diaphragm and 

 connects with the post cava. Harrison (1844) reports a case of 

 the pulmonary veins opening into the vena azygos major and 

 Schattock (1883) a case in which they opened into the systemic 

 veins. 



The following reports are of the pulmonary veins entering the 

 right atrium: Lacroix (1844), Taylor (1845), Chiari (1880), v. 

 Etlinger (1881), Epstein (1886), Hepburn (1887), and Hick- 



