Cooley D A, Duncan J M, Gillette P C, McNamara D G
Section of Cardiovascular Surgery, Texas Heart Institute, Houston 77225.
Pediatr Cardiol. 1987;8(4):257-9. doi: 10.1007/BF02427538.
We report a case of tetralogy of Fallot with an unsuspected anomalous left anterior descending coronary artery arising from the right coronary artery and crossing the right ventricular outflow tract in a 16-month-old infant. During operation, the anomalous artery was severed. Successful repair of the intracardiac anomalies was performed, including left anterior descending-internal mammary artery reconstruction of the anomalous artery. This case illustrates the importance of delineation of coronary artery anatomy and even selective coronary arteriography in patients with tetralogy of Fallot, since anomalous coronary arteries occur most frequently in association with other cardiac anomalies. Arteriography 10 years later revealed a patent anastomosis to the left anterior descending artery, proving the durability of the internal mammary artery in a patient we believe to be the youngest to have undergone bypass with this particular conduit.
我们报告了一例法洛四联症病例，该病例为一名16个月大的婴儿，其左前降支冠状动脉异常起源于右冠状动脉，并穿过右心室流出道，术前未被怀疑。手术过程中，异常动脉被切断。成功修复了心内畸形，包括对异常动脉进行左前降支-胸廓内动脉重建。该病例说明了在法洛四联症患者中描绘冠状动脉解剖结构甚至进行选择性冠状动脉造影的重要性，因为异常冠状动脉最常与其他心脏畸形相关联。10年后的动脉造影显示与左前降支动脉的吻合口通畅，证明了胸廓内动脉在我们认为是接受该特定管道搭桥手术最年轻患者中的耐用性。
