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

Objective: To study the spectrum of Tetralogy of Fallot (TOF) and its association with various congenital anomalies based on CT angiography. Methodology: This cross sectional study was conducted in Cardiology division of Lady Reading Hospital Peshawar from 1st January 2016 to 31 March 2019. All TOF patients were subjected to CT angiography for detailed assessment.The data was 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 in 16(8.2%) cases. LAD arising from right coronary artery in 4(2.05%) patients, of which 03(1.5%) was crossing RVOT. TOF with hypo-plastic pulmonary arteries were documented in 79(40.5%) patients. Of them severe main pulmonary artery hypoplasia was present in 32(16.4%), Isolated hypoplastic left pulmonary artery in 24(12.3%), right pulmonary hypoplasia in 14(7.1%) and bilateral hypoplastic pulmonary arteries in 09(4.6%) patients. Single or multiple aorto-pulmonary collaterals were documented in 65(33.3%) patients and Patent ductusarteriosus(PDA) in 45(23.1%) patients.Bilateral SVC were present in 8(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-quarter of patients with TOE One third of TOF patients had one or more aorto-pulmonary collaterals of various sizes. Left anterior descending coronary artery crossing right ventricular outflow tract (RVOT) was present in 1.5 % patients.