Intrinsic Coronary Stenosis With Ventricular Dysfunction in Tetralogy of Fallot

Intrinsic coronary anomalies in tetralogy of Fallot are rare manifestations that are difficult to diagnose, especially when accompanied by ventricular dysfunction in the postoperative period. We present a case of severe left ventricular dysfunction after repair of tetralogy of Fallot. Coronary angiography revealed intrinsic left main coronary stenosis. Therefore, we emergently performed patch augmentation of the left main coronary artery concomitantly with residual ventricular septal defect closure. While evaluating patients with tetralogy of Fallot, especially in the presence of ventricular dysfunction, intrinsic coronary anomalies should be kept in mind. Coronary angiography is effective in diagnosing coronary anomalies.