Objective: To summarize the results and experience of tetralogy of Fallot with anomalous coronary artery of surgical treatment in 19 cases. Method: From July 2000 to July 2010, nighteen patients of tetralogy of Fallot with anomalous coronary artery surgical treatment were reviewed. Aged from 8 months to 25 years old, weighting from 8.5 -52.0 kg. Including the right coronary artery originating from the left coronary artery or left anterior descending coronary artery in 6 cases, left anterior descending artery originated from right coronary artery in 9 cases, abnormal thick tapered artery in 4 cases ,all across the right ventricular outflow tract ( near the pulmonary valve annulus), One-stage correction was done in 16 cases, moderate hypothermic cardiopulmonary bypass in surgery. Using polyester film or bovine poricardial patch ventricular septal defect. Using pericardium patch or pericardium plus polyester film widen the right ventricular outflow tract,pulmonary artery. The other 3 cases of palliative surgery. Result: There were 3 cases deaths, the mortality was 15.8％, operative mortality was higher, mainly due to surgery died from low cardiac output syndrome.Conclusion: Tetralogy of Fallot with anomalous coronary artery of surgery mortality rate is higher, select the appropriate surgical approach and the right ventricular outflow tract reconstruction for improving the efficacy.But across the right ventricular outflow tract is a method of coronary artery malformation repair of tetralogy of Fallot surgery risk factors.%目的:总结对19例法洛四联症伴冠状动脉畸形的外科治疗的结果和经验.方法:对2000年7月至2010年7月施行19例法洛四联症伴冠状动脉畸形的外科治疗进行总结.年龄8个月-25岁,体重8.5-52.0 kg.其中右冠状动脉起源于左冠状动脉或前降支6例,左前降支起源于右冠状动脉9例,有异常粗大的圆锥动脉4例,均横跨右室流出道(近肺动脉瓣环处),其中一期手术16例,在中度低温体外循环下手术.采用绦纶片或者牛心包补片修补室间隔缺损.采用心包片补片或心包片加绦纶片加宽右心室流出道、肺动脉.姑息手术3例.结果:手术死亡3例,手术死亡率为15.8%,手术死亡率较高,手术死亡原因主要为低心排综合征.结论:法洛四联症合并冠状动脉畸形的手术死亡率较高,选择适当的手术方式和右室流出道重建方法可提高手术效果.但横跨右室流出道的冠状动脉畸形是法洛四联症治疗手术中的风险因素之一.
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