A method of outflow tract reconstruction in tetralogy of Fallot with anomalous anterior descending coronary artery.

An anomalous anterior descending coronary artery that arises from the right coronary and crosses the right ventricle outflow tract can compromise corrective operations for tetralogy of Fallot. The only safe method of outflow tract reconstruction reported until now is the use of a tubular graft from the right ventricle to the pulmonary artery. We report successful reconstruction of the outflow tract by placing a standard fabric path under the mobilized anomalous coronary artery. This technique should avoid the late complications of tubular conduits by preserving the natural posterior wall of the outflow tract for growth.