Anomalous coronary artery, Dual left anterior descending artery, Perioperative echocardiography, Perioperative management, Tetralogy of Fallot, Transesophageal echocardiography
Citation Information :
Das D, Choudhury A, Devagourou V. Tetralogy of Fallot with Dual Left Anterior Descending Artery: A Rare Transesophageal Echocardiographic Illustration. J Perioper Echocardiogr 2021; 9 (1):4-8.
Anomalous coronary artery (ACA) is common in tetralogy of Fallot (TOF), which influences not only surgical decision-making but also impacts perioperative management, especially when it is crossing the right ventricular outflow tract (RVOT). Optimum preoperative investigations like echocardiography and angiography decide the best practice in a patient with TOF and ACA. Perioperative transesophageal echocardiographic (TEE) assessment and intraoperative surgical findings may alter the surgical technique. TEE confirms the presence of ACA, guides surgical decision-making, and detects the lurking dangers. Among ACA, dual left anterior descending artery (dLAD) has the least incidence while it remains potentially life-threatening during intracardiac repair of congenital heart diseases (CHDs). The authors present a case of TOF with dLAD and exert the role of TEE in the perioperative management of CHDs.
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