THE SPECTRUM OF ANATOMICAL VARIATIONS IN PATIENTS WITH TETRALOGY OF FALLOT UNDERGOING DIAGNOSTIC CARDIAC CATHETERIZATION

Abstract

Objective: To determine the various anatomic associations in patients undergoing diagnostic cardiac
catheterization with Tetralogy of Fallot.
Study Design: Descriptive study.
Place and Duration of Study: Armed forces Institute of Cardiology and National Institute of Heart Diseases, from
Jan 2012 to Dec 2012
Patients and Methods: All patients with tetralogy of fallot (TOF) who underwent cardiac catheterization were
included in the study. A standard catheterization with cine-angiograms was performed and different associations
were recorded.
Results: A total 200 patients underwent catheterization during 12 months. The mean age of patients was 6.3 years
including 66% (n=132) male and 34% (n=68) female patients. The most common associated anomaly in our
patients was major aortopulmonary collateral arteries (MAPCAS) 28% (17% significant and 11% insignificant).
The other associated anomalies were right sided arch in 10%patients, additional muscular ventricular septal
defects in 4% (8) patients, persistence of left superior vena cava in 5%(10) patients, patent ductus arteriosus in 5%
(10) patients, absent left pulmonary artery in 1% (2) patients and left anterior descending coronary artery crossing
right ventricular outflow tract (RVOT) in 1%patients. There was no cardiac perforation, tamponade, cardiac arrest
or death during this period.
Conclusion: Major aortopulmonary collateral arteries remained the most common finding which necessitated
early diagnosis and management in order to prevent long term complications.