Tetra ostial coronary anatomy- A rare pattern in transposition of great arteries.

Meticulous transfer of coronary arteries is of crucial importance in transposition of great arteries and determines the success of the switch procedure. This report describes a coronary anatomy consisting of four separate ostia from the two facing sinuses in a six-month-old infant presenting with d-transposition of great arteries and ventricular septal defect. Being a rare coronary arterial pattern not described in previous coding systems, the surgeon would do well to be aware of this possibility while performing the switch procedure.