An Unusual Cause of Pulmonary Artery Aneurysm in an Adult With Repaired Tetralogy of Fallot

Abstract A 44-year-old male with repaired tetralogy of Fallot (TOF), initially palliated with a Potts shunt in infancy, presented decades later with NYHA class II symptoms. Imaging revealed a progressively enlarging aneurysm of the left lower pulmonary artery (PA), supplied by a persistent Potts shunt, once the upper branch of the PA was mistakenly ligated at the time of the Fallot repair. After years of conservative monitoring, he underwent successful percutaneous closure of the shunt using an Amplatzer device. Post-procedural imaging confirmed thrombosis and reduction of the aneurysm, with resolution of mild exertional dyspnea.