[Tetralogy of Fallot with coronary-to-pulmonary artery fistula: a diagnostic snare].

An 11-month-old infant, moderately cyanotic, with diagnosis of tetralogy of Fallot underwent corrective surgery. At echocardiographic evaluation, a subatretic right ventricular outflow tract without aortopulmonary collateral arteries, confluent pulmonary arteries and normal coronary pattern were evidenced. During operation, an undiagnosed large coronary-to-pulmonary artery fistula was disclosed. Because of the large variety of aortopulmonary collateral arteries that can be associated with this pathology, further imaging study is mandatory when oxygen saturation does not match the right ventricular outflow tract obstruction severity.