Repair of Divided Anomalous Anterior Descending Coronary Artery in Tetralogy of Fallot

Coronary artery anomalies in tetralogy of Fallot have often compromised surgical repair and imposed an increased mortality rate. Thus accidental division of the anterior descending coronary artery crossing the right outflow tract has previously usually resulted in death. The case is presented of a 13-year-old boy with tetralogy of Fallot in whom the anomalous left anterior descending coronary artery was divided. The blood supply to the left anterior descending artery was successfully restored using a reversed saphenous vein graft.