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Ann Thorac Surg 1999;67:1178-1180
© 1999 The Society of Thoracic Surgeons

How To Do It

Tetralogy of Fallot with anomalous coronary artery: double outflow technique

B. Reddy Dandolu, MDa,b, H. Scott Baldwin, MDa,b, William I. Norwood, Jr, MD, PhDa,b, Marshall L. Jacobs, MDa,b

a Division of Cardiothoracic Surgery, Deborah Heart and Lung Center, Browns Mills, New Jersey, USA
b Divisions of Pediatric Cardiology and Cardiovascular Surgery, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

Accepted for publication September 16, 1998.

Address reprint requests to Dr Jacobs, Section of Cardiothoracic Surgery, St. Christopher’s Hospital for Children, Erie Ave at Front St, Philadelphia, PA 19134

A new technique to repair tetralogy of Fallot with an anomalous coronary artery crossing the right ventricular outflow tract is described, together with intermediate term follow-up. Using a pedicled flap of the anterior pulmonary artery wall as the floor, and a vascular or prosthetic patch as the roof, a composite conduit with the potential for growth is constructed. Together with the native outflow tract, this provides unobstructed egress from the right ventricle to the branch pulmonary arteries. Since 1990, 4 infants aged 2-weeks to 6-months have undergone primary repair using this technique. Intermediate term follow-up shows adequate durability of the repair.




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