Aortic aneurysm formation five decades after tetralogy of Fallot repair.

Surgical repair of tetralogy of Fallot is recognized as one of the most successful palliative cardiac surgical procedures. We report a patient in whom cystic medial necrosis developed 50 years after tetralogy of Fallot repair that caused a pathologic ascending aortic aneurysm requiring operative repair. Thus, long-term clinical follow-up along with echocardiography, when indicated, is mandatory in patients undergoing tetralogy of Fallot repair.