THE SPECTRUM OF TETRALOGY OF FALLOT AND ITS ASSOCIATION WITH VARIOUS CARDIAC AND EXTRA CARDIAC CONGENITAL ANOMALIES: A MULTI SLICE CT BASED STUDY

Abstract

Objective: To study the spectrum of Tetralogy of Fallot (TOF) and its associationwith various congenital anomalies based on CT angiography.

Methodology: This cross sectional study was conducted in Cardiology divisionof Lady Reading Hospital Peshawar from 1st January 2016 to 31 March 2019. AllTOF patients were subjected to CT angiography for detailed assessment.The datawas analyzed via SPSS version 21.

Results: A total of 195 of Tetralogy of Fallot (TOF) were included in the study.Their mean age was 3.2±0.8 years. Coronary anomalies were present in16(8.2%) cases. LAD arising from right coronary artery in 4(2.05%) patients, ofwhich 03(1.5%) was crossing RVOT. TOF with hypo-plastic pulmonary arterieswere documented in 79(40.5%) patients. Of them severe main pulmonary arteryhypoplasia was present in 32(16.4%), Isolated hypoplastic left pulmonary arteryin 24(12.3%), right pulmonary hypoplasia in 14(7.1%) and bilateral hypoplasticpulmonary arteries in 09(4.6%) patients. Single or multiple aorto-pulmonarycollaterals were documented in 65(33.3%) patients and Patentductusarteriosus(PDA) in 45(23.1%) patients.Bilateral SVC were present in8(4.1%) patients. Right sided aortic arch was documented in 24(12.3%)patients.

Conclusion: A right aortic arch was present in one-eighth and PDA in one-quarterof patients with TOF. One third of TOF patients had one or more aorto-pulmonarycollaterals of various sizes. Left anterior descending coronary artery crossingright ventricular outflow tract (RVOT) was present in 1.5%patients.