Aneurysm of the pulmonary artery. Rare long term complication of central aorto-pulmonary shunts for congenital heart disease. Report of two cases with review of the literature.

Aneurysm of the left pulmonary artery developed in two patients with tetralogy of Fallot at the site of a Potts' shunt. Although such a complication is known we could not find any previously reported case of successful surgical treatment in the literature. Cardiac catheterization and angiography provided the definitive diagnosis. One patient refused surgical intervention but later presented with fatal rupture and massive hemoptysis. Closure of the Potts' shunt, angioplastic repair of the pulmonary artery aneurysm and total correction of tetralogy of Fallot were successfully accomplished using cardiopulmonary bypass and cardioplegic arrest. Aneurysm should be suspected whenever a mediastinal mass appears in patients with a previous systemic-pulmonary artery shunt.