Coronary anomalies in Pakistani children with tetralogy of Fallot.

OBJECTIVE To determine coronary artery anomalies in tetralogy of Fallot in Pakistani children as seen on angiography. STUDY DESIGN Case series. PLACE AND DURATION OF STUDY The National Institute of Cardiovascular Diseases, Karachi, Pakistan from July 2006 to July 2007. METHODOLOGY Children under 15 years of age with echocardiographic diagnosis of tetralogy of Fallot were included in the study. All patients had pre-operative cardiac catheterization and angiography. Coronary arteries were studied with a nonselective aortic root angiogram in standard cranially tilted left anterior oblique view. The frequency of a normal and an anomalous coronary was determined. RESULTS Of the 83 patients, 78% were male and had a mean age of 8.9 years. Their mean weight was 14.3 kilograms. Seventy six (91.6%) had a normal coronary anatomy while 7 (8.4%) patients had anomalous coronary arteries. Among the patients with coronary anomalies, the commonest was a single origin coronary artery in 04 (57.14%) cases. Three (42.86%) had an anomalous origin of left anterior descending artery from the right coronary artery. CONCLUSION Coronary artery anomalies were detected in 8.4% of the cases with tetralogy of Fallot. Single origin coronary artery anomaly was the commonest anomaly.