Total anomalous pulmonary venous drainage (TAPVD) is encountered less frequently in infancy than various other congenital cardiac anomalies. We present a 4-week-old boy with a hitherto unreported variant of TAPVD who died suddenly soon after presentation to our emergency department. At autopsy, we found both pulmonary veins draining abnormally into the pulmonary artery and an atrial septal defect. We wish to emphasize that examination of the major vessels and their connections should be done in situ in all autopsies of unexpected deaths in infants and children, even if there were no symptoms and signs in the ante-mortem period and despite the clinical picture not being suggestive of TAPVD.
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