Surgically important coronary artery anomalies may be seen uncommonly in tetralogy of Fallot. The most commonly encountered anomaly is the abnormal origin of the left anterior descending coronary artery from the right coronary artery crossing the right ventricular outflow tract. Many different techniques have been described for repair of tetralogy of Fallot with a coronary anomaly. We performed a single right ventriculotomy parallel and distal to the course of the left anterior descending coronary artery that crossed the right ventricular outflow tract in a seven-year-old boy, alleviating the right ventricular outflow tract obstruction without damaging the left anterior descending coronary artery. The pulmonary annulus was enlarged with a pericardial patch through the parallel ventriculotomy, and the patient was discharged without any problem. Our technique has the advantages of leaving the anomalous coronary artery intact throughout the operation, relieving right ventricular outflow tract obstruction easily and satisfactorily, allowing transannular patch application without any damage to the coronary artery, avoiding strecthing of the coronary artery along its course through linear closure of the right ventriculotomy, and avoiding any conduit or valve use.

Keywords : Coronary angiography; follow-up; tetralogy of Fallot/ complications/radiography/surgery