Those pesky anomalous coronary arteries: The importance of recognition before surgical repair of congenital cardiac disease and those mysterious Q waves

Abstract

Keypoints Most infants with tetralogy of Fallot have staged surgical repairs of this complex congenital cardiac anomaly. Coronary anomalies occur in a tetralogy about 5% of the time. The most common coronary anomaly in the tetralogy of Fallot is an anomalous takeoff of the left anterior descending coronary artery of the right coronary artery which can be plicated during complete repair of the defect when the obstructed RV outflow tract is surgically opened.