Internal mammary-anomalous left anterior descending coronary artery graft in 16-month-old infant with tetralogy of Fallot: 30-month follow-up.

Congenital anomalies of the coronary arteries can occur in conjunction with tetralogy of Fallot. We describe a case of unsuspected anomalous origin if the left anterior descending coronary artery arising from the right coronary artery that was discovered at the time of operation in a 16-month-old infant with tetralogy of Fallot. Successful direct vascular repair of the intracardiac anomalies was performed, including left internal mammary-coronary artery anastomosis. The patient, whom we believe to be the youngest to undergo this technique, underwent cardiac catheterization 21 months after operation. The successful results were confirmed at that time.