PULMONARY ARTERY VARIANTS AND ASSOCIATED CARDIAC DEFECTS IN TETRALOGY OF FALLOT

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.