A neglected adult case with TOF and pulmonary atresia. a, b 3D VRT MDCT images showing innumerous MAPCAs filling the mediastinum arising from descending thoracic aorta as well as right and left subclavian and internal mammary arteries. c, d Reconstructed MDCT coronal images showing pulmonary atresia and non-confluent right and left pulmonary arteries arising from MAPCAs rather than main pulmonary artery (red arrows). e A reconstructed MDCT sagittal image showing ascending aortic aneurysm as a result of long-standing volume loading in this patient. Ao, aorta; RPA, right pulmonary artery; LPA, left pulmonary artery; LV, left ventricle; RV, right ventricle; LA, left atrium.