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Tetralogy of Fallot with Systemic Arterial Supply

Imaging findings

Classic Tetralogy of Fallot findings (overriding aorta, VSD) with an unusual systemic collateral supply arising from abdominal vessels (inferior phrenic) to the lower lobes.

Key takeaways

Complex congenital heart disease can feature rare systemic-to-pulmonary collaterals that require careful mapping during evaluation.

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