[Congenital coronary artery anomalies in patients with tetralogy of Fallot].

OBJECTIVE: The aim of the study was to establish frequency of congenital coronary arteries anomalies in patients with tetralogy of Fallot; to evaluate importance of early diagnostics in planning of surgical tactics and impact on early surgical results.

MATERIAL AND METHODS: Consecutive retrospective analysis of angiography data of 278 patients with tetralogy of Fallot and 219 surgical protocols of total corrections of tetralogy of Fallot was performed.

RESULTS: Twenty coronary arteries anomalies were diagnosed by means of angiography and 2 during surgery. Sixteen patients with coronary arteries anomalies underwent total tetralogy of Fallot correction. For all of them two stage strategy (palliative operation before total correction) was chosen. Correction by means of extracardiac conduit was performed in 5 (31.25%) patients, right ventricular infundibulectomy via right atrium in one patient. Modified ventriculotomy was performed for 8 patients.

CONCLUSIONS: 1. Coronary arteries anomalies have been found in approximately 8% patients with tetralogy of Fallot. 2. For infants with tetralogy of Fallot and coronary arteries anomalies two stage strategy was chosen, so total correction has been made in older patients. 3. In order to prevent anomalous coronary arteries injury, alternative correction of right ventricle obstruction has been chosen. Total tetralogy of Fallot correction using pulmonary artery conduit was made in 31.3% of the patients.