The case is reported of a 62 year-old male having a clinical history of grade II dyspnoea from 9 year ago and recently showing grade II angina. He had presented mild cyanosis. Suspecting the existence of coronary arteriosclerosis, and with the clinical diagnosis of tetralogy of Fallot based particularly on two-dimensional and M-mode echocardiography, and angio-hemodynamic study was made which confirmed the presence of congenital heart disease and also revealed significant coronary lesions of the circumflex and right coronary arteries. The patient underwent surgery which involved complete correction of the tetralogy of Fallot and the placing of two aortocoronary grafts onto the circumflex and right coronary arteries. Favorable progress was noted both immediately after operation and 6 months later. Although cases have been described of Fallot disease associated with acute myocardial infarction, we believe that this is the first time a patient has undergone myocardial revascularization at the same time as undergoing complete correction of the congenital heart disease.