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Tetralogy of Fallot correction with transannular patch reconstruction in a patient with an anomalous right coronary artery and an unusual course of the right ventricular branch

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Abstract

Anomalous coronary arteries occur in as many as 12% of patients with tetralogy of Fallot (TOF). In patients with this condition, pulmonary hypoplasia can be prohibitive in performing a valve-sparing repair, subsequently resulting in various techniques to preserve the anomalous coronary artery. The management strategy is often complex in such a situation. We report on a case of TOF with an anomalous right coronary artery crossing the right ventricular outflow tract, with an unusual course of the right ventricular (RV) branch, which precluded placement of a valved conduit. In this case, we performed a successful repair with mobilization of the anomalous coronary artery and reconstruction of the right ventricular outflow tract with a limited transannular patch.

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Acknowledgments

We would like to thank Dr. Balaji Srimurugan from Amrita Institute of Medical Sciences (Kochi, India) for his kind assistance in the medical illustration (Figure 2).

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, National Heart Institute, Kuala Lumpur, Malaysia

    Sabrina Anne Gonzalez & Sivakumar Sivalingam

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  1. Sabrina Anne Gonzalez
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  2. Sivakumar Sivalingam
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Both authors contributed equally to the preparation and writing of the manuscript, and approved the final manuscript.

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Correspondence to Sabrina Anne Gonzalez.

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The authors declare that they have no conflict of interest.

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This case report was conducted in a retrospective manner, from data obtained clinically. This case report was conducted in accordance with the ethical standards of the institutional and national research committees, and with the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was taken from the patient’s legal guardians.

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Gonzalez, S.A., Sivalingam, S. Tetralogy of Fallot correction with transannular patch reconstruction in a patient with an anomalous right coronary artery and an unusual course of the right ventricular branch. Indian J Thorac Cardiovasc Surg 37, 329–333 (2021). https://doi.org/10.1007/s12055-020-01074-0

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  • DOI: https://doi.org/10.1007/s12055-020-01074-0

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