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Ann Thorac Surg 2004;77:321-322
© 2004 The Society of Thoracic Surgeons

Case report

Coronary artery obstruction due to membranous ridge of the right sinus valsalva associated with Tetralogy of Fallot: syncope mimics anoxic spell

Isao Shiraishi, MDa*, Masaaki Yamagishi, MDb, Kentaro Toiyama, MDa, Yu Osawa, MDc, Masao Nakagawa, MDc, Akiyuki Takahashi, MDb, Keisuke Shuntoh, MDb, Kenji Hamaoka, MDa

a Department of Pediatrics, Kyoto, Japan
b Department of Pediatric Cardiovascular Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
c Department of Pediatrics, Shiga University School of Medicine, Shiga, Japan

Accepted for publication April 29, 2003.

* Address reprint requests to Dr Shiraishi, Division of Pediatrics, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan 602-8566.
e-mail: isao{at}koto.kpu-m.ac.jp

We report an infant with Tetralogy of Fallot who had suffered from repetitive attacks of syncope without obvious cyanosis. Careful observation by means of echocardiography and angiography revealed that the attacks resulted from acute coronary artery obstruction due to membranous ridge covering the sinus Valsalva. Surgical resection of the abnormal ridge and repair of Tetralogy of Fallot successfully improved the patient's symptoms. Syncope in children should be extensively investigated to exclude obstruction of the coronary arteries.






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