title: Frequency, origins and courses of anomalous coronary arteries in 607 Turkish children with tetralogy of Fallot.
abstract: BACKGROUND
  The aim of this study was to investigate the incidence, origins and courses of coronary artery anomalies using a combination of angiographic and surgical methods in Turkish children with tetralogy of Fallot (ToF).
  
  
  METHODS
  Seventy-seven patients in whom coronary artery anomalies had been identified by angiography and/or at operation out of 549 ToF and 58 Fallot-type double outlet right ventricle (total 607) patients, were enrolled in the study.
  
  
  RESULTS
  Coronary artery anomalies were identified in 12.7% of the patients. The incidence was 12.2% (67/549) in patients with aortic overriding 50%, and 17.2% (10/58) with aortic overriding 〉 50% (p 〉 0.05). The incidence of anomalous coronary arteries crossing the right ventricular outflow tract (RVOT) was 7.91%. The commonest anomaly was the left anterior descending artery (LAD) or accessory LAD arising from the right coronary artery (RCA; n = 25). Other frequent anomalies were single coronary ostium (n = 21) and enlarged conal branch of RCA (n = 18). In 62.3% (48/77) of the patients with a coronary anomaly, the anomalous vessels were crossing the RVOT. The ratio of crossing the RVOT was 92.0% for LAD arising from the RCA, 66.7% for conal branch, and 42.9% for single coronary ostium.
  
  
  CONCLUSIONS
  Two thirds of the anomalous coronary arteries were crossing the RVOT, and had surgical importance. The most frequent coronary artery anomaly that crossed the RVOT was the LAD or the accessory LAD arising from the RCA. Also, an enlarged conus artery should be considered as an anomaly because of its surgical importance, given its high rate of crossing the RVOT.
authors.affiliation: Department of Pediatric Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey. mkervancioglu@gantep.edu.tr
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kervancioglu
authors.forename: Kursad
authors.initials: K
authors.lastname: Tokel
authors.forename: Birgul
authors.initials: B
authors.lastname: Varan
authors.forename: Selman Vefa
authors.initials: SV
authors.lastname: Yildirim
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013771:Tetralogy of Fallot / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D014421:Turkey / Q000453:epidemiology