Tetra ostial coronary arterial anatomy-A rare pattern in transposition.

Background: Meticulous transfer of coronary arteries is of crucial importance in transposition and determines the success of the switch procedure. This report describes a coronary arterial anatomy consisting of four separate ostia from the two facing sinuses in a 6-month-old infant presenting with transposition and ventricular septal defect.

Conclusion: 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.