Prenatal diagnosis of tetralogy of Fallot associated with a fistula from the left coronary artery to the left atrium

In a fetus at 20 weeks gestation, we found a large fistula from the left coronary artery to the left atrium in association with tetralogy of Fallot. Postnatally, the therapeutic issues were complex because of prematurity, low birth weight, decreased flow of blood to the lungs, and volume overload of the left ventricle because of the huge fistula. At three months, the baby underwent repair of tetralogy of Fallot, with surgical ligation of the fistula, but the baby died postoperatively.