title: Congenital extracardiac shunts with tetralogy of Fallot.
abstract: Congenital extracardiac shunts in tetralogy of Fallot may significantly alter the history and clinical findings and also have significant management implications. An unusual variant of severe tetralogy of Fallot in a 54-year-old man enabled long survival with minimal symptoms. The patient had pulmonary valvular and infundibular stenosis, a large ventricular septal defect, an overriding aorta, and large volume systemic-to-pulmonary artery shunting from his right internal mammary and accessory internal mammary arteries to his right pulmonary artery.
mesh_terms: D003326:Coronary Circulation; D006345:Heart Septal Defects, Ventricular / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008323:Mammary Arteries; D008875:Middle Aged; D011651:Pulmonary Artery; D011652:Pulmonary Circulation; D011666:Pulmonary Valve Stenosis / Q000150:complications; D011859:Radiography; D013771:Tetralogy of Fallot / Q000150:complications* / Q000000981:diagnostic imaging