A Rare Case of Uncorrected Tetralogy of Fallot With Right Hemitruncus in an Adult Survivor Highlighting the Role of Cardiac Computed Tomography.

Tetralogy of Fallot (TOF) is one of the most common congenital cardiac anomalies. The association of TOF with anomalous aortic origin of pulmonary artery (Hemitruncus) is, however, exceedingly rare. Survival into adulthood without surgical correction is itself unusual and typically depends on compensatory Major Aortopulmonary Collateral Arteries (MAPCAs). We present a case of a 30-year-old man who presented with recurrent hemoptysis and cough. Electrocardiogram (ECG)-gated cardiac computed tomography (CT) revealed the classical features of TOF, along with an atretic main pulmonary artery, right Hemitruncus, and reformation of the left pulmonary artery by multiple MAPCAs. This case illustrates the role of Cardiac CT for this exceptionally rare congenital heart anomaly in an adult survivor for anatomy delineation and treatment planning in this setting, which poses a management challenge.