Surgical management of tetralogy of Fallot with anomalous coronary artery

Fifteen patients of tetralogy of Fallot with an anomalous left anterior descending coronary artery arising from the right coronary artery were operated during a period of 1982 and 1988. One patient died in the early post-operative period (6.6%). Two patients had a hemodynamically insignificant residual ventricular septal defect. Post-operative peak systolic pressure gradient between the right ventricle and pulmonary artery ranged from 10 mm Hg to 40 mm Hg (mean 24 mm Hg) in 4 patients. There was no incidence of inadvertent coronary artery division.