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Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Less than 3% of all patients with uncorrected TOF reach their 40 th year of life. We present the case of a 58-year-old woman female with uncorrected TOF. The main factors contributing to her longevity are the early development of aortopulmonary collaterals channels and the relatively gradual narrowing of the right ventricular outflow tract.

Usually diagnosed on post-mortem, aortopulmonary artery fistula is an exceptionally rare and often highly lethal condition. Here, we present a unique case of a 29-year-old woman with no history of aortic aneurysm or previous aortic surgery, referred for surgical management of Laubry-Pezzi syndrome in whom an aorto-pulmonary artery fistula bridging the ascending aorta and the main pulmonary artery was discovered intra operatively. The patient was successfully managed with an uneventful postoperative recovery.