Complex pulmonary atresia in an adult: natural history, unusual pathology and mode of death

A patient with unrepaired complex pulmonary atresia had a normal life, achi eving two successful pregnancies, until the age of 44 years. Confluent cent ral pulmonary arteries were supplied by a fistulous communication from the left coronary artery, and from other collateral arteries arising from the u nderside of the aortic arch. Unusual aneurysms were present. Death at the a ge of 46 resulted from dissection and rupture of an aneurysmal dilation of the pulmonary trunk.