Large systemic collateral arteries developing late after total repair of tetralogy of Fallot.

A 22-year-old man with tetralogy of Fallot successfully underwent a corrective operation. Twenty years after total correction, large systemic collateral arteries (SCA) developed. The SCA arose from the right subclavian and internal mammary arteries. The SCA were not present at the time of total repair and thoracotomy had not been performed on this side. A closed-tube thoracostomy for postoperative pneumothorax may be responsible for the development of the large SCA.