Shahid Modarres Hospital, Saadat Abad, Tehran , Iran


Background- Anomalous coronary artery disease is more common among patients with Tetralogy of Fallot (ToF).
Methods- In order to determirie the coronary anomalies in patients with ToF, 135 patients (80 males) with ToF, 9 months to 40 years of age vere studied over 7 years (1995-2002) at Modarres Hospitalin Tehran, Iran.
Results-Eight out of the 135 patients (4 males) with Tof were associated with a surgically- relevant coronary artery anomaly (5.9%). The anomalous coronary arteries consisted of single ostium of the coronary artery (n =5), the left anterior descending coronary artery originating from the right coronary artery (n= 2) or single righf coronary artery (n = 2) and the right coronary artery arising from the left coronary artery (n = 1). Surgical technique employed in three ToF patients was transverse incision on the right ventricle, and commissurotomy via the pulmonary artery was the technique used for three other patients. In another patient, a composite graft between the right ventricle outflow tract and main pulmonary artery was inserted. In the remaining four patients with single ostium coronaries, routine repairs were done.
Conclusions-Anomalous coronary artery disease is more common among patients with ToF. Bearing these anomalies in mind during primary repair could decrease the risk of surgery in patients with ToF