Coronary artery--pulmonary artery fistula in tetralogy of Fallot with pulmonary atresia.

The treatment of a rarely described variant of tetralogy of Fallot with pulmonary atresia is reported. The case is unique because the patient remained relatively pink although the pulmonary blood flow came solely from a fistula between the left coronary artery and the main pulmonary artery. The diagnostic and surgical implications are discussed and the literature briefly reviewed. The diagnosis should be borne in mind in patients who have pulmonary atresia with ventricular septal defect and a continuous murmur.