Aortic dissection in a Chinese patient 31 years after surgical repair of tetralogy of Fallot

Aortic dilation has been increasingly recognized in congenital heart diseases, and aortic dissection is one of the important complications. We report a case of aortic dissection in a patient 31 years after repair of tetralogy of Fallot (TOF) and review reported cases. While aortic dissection is uncommon, aortic dilation is common among patients with repaired TOF and it appeared progressive in some patients. Based on the reported cases, progressive aortic dilation appeared as the pre-requisite for aortic dissection, although other factors might be involved. Regular surveillance and monitoring for aortic complications should be incorporated into clinical practice. <Learning objective: Aortic dilation is common but aortic dissection is uncommon in patients with tetralogy of Fallot, and threshold for prophylactic surgery is lacking. Recognition of progressive aortic dilation is important to identify patients at risk of aortic dissection in tetralogy of Fallot.>.