A symptomatic neonate with tetralogy of Fallot, an absent pulmonary valve, and a single coronary artery with a major fistula.
We present a case with a rare combination of tetralogy of Fallot with an absent pulmonary valve, and a single coronary artery with a major fistula to the main pulmonary artery. Myocardial ischemia developed in response to increasing shunt flow through the coronary fistula, resulting in heart failure. We ligated the coronary fistula and plicated the anterior wall of the dilated pulmonary arteries during the neonatal period. Complete repair through a transatrial-transpulmonary approach was performed at the age of 17 months. The postoperative course was excellent and the patient maintained a stable hemodynamic and respiratory state with no evidence of myocardial ischemia.
Kajihara
Noriyoshi
N
Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, Japan. n-c.kaji@f6.dion.ne.jp
Asou
Toshihide
T
Takeda
Yuko
Y
Kosaka
Yoshimichi
Y
Matsuhama
Minoru
M
Onakatomi
Yasuko
Y
Yanagi
Sadamitsu
S
Yasui
Seiyo
S
D000015:Abnormalities, Multiple / Q000601:surgery*; D003330:Coronary Vessel Anomalies / Q000601:surgery*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011651:Pulmonary Artery; D011664:Pulmonary Valve / Q000002:abnormalities*; D013771:Tetralogy of Fallot / Q000601:surgery*; D016157:Vascular Fistula / Q000601:surgery*