Intracardiac shunts consequent to penetrating thoracic injury have been reported in 94 patients. Two additional cases are reported emphasizing the frequently complex anatomic abnormalities, the variability in clinical course, and the favorable outcome of repair. From a review of the literature, it is apparent that most such lesions should be corrected, since patients are at a continual risk of symptomatic cardiac dysfunction and repair offers an excellent prognosis with minimal morbidity.