Abstract: Objective To analyze the surgical treatment of tetralogy of Fallot (TOF) with anomalous coronary artery (ACA) crossing the right ventricular outflow tract (RVOT), in order to improve the outcome of the disease. Methods The clinical data of 26 patients of TOF with ACA crossing the RVOT of Fu Wai Hospital from Oct.1996 to Feb.2006 were analyzed retrospectively. A double ventriculotomy superior and inferior to ACA were used in 11 patients, one ventriculotomy inferior to ACA were used in 6 patients and superior to ACA for 4 patients, 2 patients needed extra cardiac conduits, and 3 patients received other approaches. Results There were 2 operative death （7.7%）and no late deaths. Follow-up was extended 1 to 100 months, all of them had no residual ventricular septal defect(VSD) and their right ventriclepulmonary artery gradient were 27.3±15.6 mmHg. Conclusion Preoperative identification of ACA in patients with TOF is necessary. The surgeon should be careful in inspection of distribution of coronary artery during operation, and undergo the individualized surgical procedures based on the extent of RVOT obstruction and distribution of the ACA.
Objective To investigate how to choose the methods of surgical treatment for Scimitar syndrome. Methods From Jan. 1999 to July 2004, the clinical data of 12 patients with Scimitar syndrome were analyzed retrospectively, 10 patients underwent repair by intra-atrial baffles approach, one patient by connecting scimitar vein and left atrium with artificial blood vessel under cardiopulmonary bypass, and one patient by directly reimplanting the scimitar vein to left atrium without cardiopulmonary bypass. Results All the 12 patients had no perioperative or late deaths and none of them required reoperation. Follow-up was extended from 1 to 36 months, echocardiography demonstrated a patent anastomosis in all patients without any evidence of restenosis. Conclusions Surgical approaches to Scimitar syndrome is based on the anatomic and pathologic features presented in each case. Approriate method will have good result.