Transatrial-transpulmonary tetralogy of fallot repair is effective in the presence of anomalous coronary arteries

Tetralogy of Fallot with Anomalous Left Anterior Descending Coronary Artery : A Rare Repair – A Case Report and Review of Literature

“…Several techniques have been advocated for circumventing this situation for achieving total correction. 8,10 Usually repair through the RA, RV and pulmonary artery(PA) is done but trans-atrial (TA) or a combination of TA and transpulmonary(TP) repair is possible only when the pulmonary annulus is considered adequate. 10 Surgical treatment continues to evolve for annular hypoplasia associated with anomalous coronary vessel.…”

“…8,10 Usually repair through the RA, RV and pulmonary artery(PA) is done but trans-atrial (TA) or a combination of TA and transpulmonary(TP) repair is possible only when the pulmonary annulus is considered adequate. 10 Surgical treatment continues to evolve for annular hypoplasia associated with anomalous coronary vessel. 8 When significant degrees of hypoplasia of pulmonary valve annulus and the MPA is frequently encountered, the most preferred surgical option in such a situation is placement of a conduit interposition between RV and MPA.…”

Surgical strategy for tetralogy of Fallot with abnormal coronary arteries

“…The are some anomaly patterns as: origin of the left anterior descending coronary artery (LAD) from right coronary artery (RCA), RCA rising from left coronary artery (LCA), origin of RCA from left descending coronary artery, large conal artery rising from RCA, and only one RCA (7).…”

“…In the last situation, the surgeons can perform a transatrialtranspulmonary approach with the technical advantage to perform a repair though there is an anomaly coronary artery on the infundibulum, avoiding a more extensive and demolitive repair (7). Already in 1998, Brizard et al (7) after correction in 36 of 611 patients (5.9%), affirmed that an important coronary crossing the infundibulum in TOF can be corrected by the transatrial-transpulmonary approach frequently without many changes in technique.…”

“…Already in 1998, Brizard et al (7) after correction in 36 of 611 patients (5.9%), affirmed that an important coronary crossing the infundibulum in TOF can be corrected by the transatrial-transpulmonary approach frequently without many changes in technique. In fact, the results appeared similar to those of others patients with TOF and in conclusion the authors affirmed that the presence of coronary anomalies did not increase the risk after this surgical correction.…”