A shunt from the brain: left internal carotid artery arising from the left pulmonary artery in tetralogy of Fallot.

Origin of a common carotid artery from a pulmonary artery is extremely rare, but isolated origin of an internal carotid artery from a pulmonary artery with intracardiac anomaly has not been reported before. We report a case of the left internal carotid artery arising from the left pulmonary artery in a case of tetralogy of Fallot. The possible embryologic mechanism and the surgical management of this unique lesion are described.