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Abstract
Among patients with the anomaly named in the title some exhibit evidence of pulmonary venous obstruction, while others do not. When pulmonary venous obstruction occurs it may be explained by (1) intrinsic stenotic lesions within the anomalous vein ("anomalous vertical vein ") that carries blood from the pulmonary veins to the left innominate vein or by (2) compression of the anomalous vertical vein because of an unusual course. Usually the anomalous vein runs anterior to the left pulmonary artery. When it runs posterior to the artery, as is less common, it is compressed as it lies in the confined space between the left pulmonary artery, anteriorly and the left main bronchus, posteriorly.

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