PULMONARY ARTERY VARIANTS AND ASSOCIATED CARDIAC DEFECTS IN TETRALOGY OF FALLOT

Abstract

Objective: To see the frequency of pulmonary artery abnormalities and other
associated cardiac anomalies in patients of tetralogy of Fallot (TOF).
Methodology: This was a descriptive cross-sectional study. All patients of TOF
who underwent angiographic study for the diagnosis of pulmonary artery malformations
and other associated cardiac defects from January 2014 to June
2016 were selected for this study. MS Excel 2013 software was used for data
compilation and analysis. Percentages and mean±SD were used to present
qualitative and quantitative variables respectively.
Results: Out of 209 patients, 142 (67.9%) were male and 67 (32.1%) female.
Mean age of the patients at the time of presentation was 7.65 ±5.84 years.
Left pulmonary artery stenosis was the most common abnormality present in
27 (12.9%) patients, main pulmonary artery hypoplasia in 19 (9.1%), and right
pulmonary artery hypoplasia in 6 (2.9%) patients. Absent pulmonary valve syndrome
along with TOF was diagnosed in 2 (0.95%) patients. Associated cardiac
defects were present in 82 (39.2%) patients, right aortic arch was the most common lesion presented in 36 (17.2%) patients, major aorto-pulmonary collaterals in 15 (7.2%), bilateral superior vena cava (SVC) in 10 (4.8%) and patent ductus arteriosus in 6 (2.9%) patients. Coronary artery abnormalities were diagnosed in 6 (2.9%) patients. Additional VSD was diagnosed in 4 (1.9%) patients and double aortic arch in 1(0.47%) patients. There was one patient with complete
absence of IVC with azygous continuation.

Conclusion: Left pulmonary artery origin stenosis and main pulmonary artery
hypoplasia were most common pulmonary artery abnormalities. Right aortic
arch and major aorto-pulmonary collaterals were most common associated
cardiac abnormalities in TOF patients.