Ventricular Dysfunction in a 40-Year-Old With Coronary Compression From Aortic Aneurysm Following Waterston Shunt and Complete Repair of Tetralogy of Fallot

Tetralogy of Fallot (TOF) is the most prevalent form of cyanotic congenital heart disease in the adult population and requires life-long follow-up with a specialist in adult congenital heart disease to closely monitor for known long-term complications.1, 2 Common complications seen in TOF include aortic root dilation and sequelae related to right ventricular volume overload, although they can differ depending on the surgical history.3, 4 Recommendations for surveillance include annual imaging with either echocardiography or cardiac magnetic resonance imaging to evaluate anatomy and hemodynamics.1, 5 We present a case of an unusual complication related to surgical palliation in an adult with TOF requiring multimodality imaging for diagnosis.