Open Access

ARTICLE

Surgical Treatment of Anomalous Left Coronary Artery Originating from the Pulmonary Artery: A Single-Center Experience

Guozhen Wang^1,2, Yong An^1,2,*

1 Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University, National Clinical Medical Research Center for Children’s Health and Diseases, Key Laboratory of the Ministry of Education for the Study of Childhood Developmental Diseases, Chongqing, 401122, China
2 Chongqing Key Laboratory of Structural Birth Defects and Organ Repair and Reconstruction, Chongqing, 401122, China

* Corresponding Author: Yong An. Email:

Congenital Heart Disease 2025, 20(3), 347-355. https://doi.org/10.32604/chd.2025.065354

Received 10 March 2025; Accepted 25 June 2025; Issue published 11 July 2025

Abstract

Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomalous coronary artery origin disorder. Objective: We sought to summarize the clinical experience and prognostic characteristics of surgical treatment of ALCAPA. Methods: We retrospectively analyzed clinical information on patients who had ALCAPA and underwent surgery at our center from February 2016 to October 2023. Results: This comparative study of 23 ALCAPA patients (9 infants <1 year; 14 children >1 year) demonstrated significant age-dependent outcomes. Infant patients exhibited markedly prolonged mechanical ventilation (183 ± 105.6 vs. 48.5 ± 62.2 min, p = 0.001) and hospitalization (30.8 ± 8.2 vs. 19.5 ± 6.2 days, p = 0.001), despite comparable operative times (p > 0.05). The perioperative mortality rate was 8.7% (2/23). Early postoperative mortality showed a non-significant trend in infants (22.2% vs. 0%, p = 0.11). Serial follow-up revealed substantial functional improvement, with abnormal left ventricular ejection fractions decreasing from 56.5% preoperatively to 14.3% at 1-month (p < 0.01), and severe mitral regurgitation declining from 34.7% to 14.3%. However, persistent left ventricular enlargement (81% at follow-up) and moderate mitral regurgitation (52.4%) were frequently observed. Conclusion: Surgical correction of ALCPA effectively restores coronary perfusion and reduces severe mitral regurgitation, though residual ventricular dilation and moderate valvular dysfunction persist in the short-term postoperative period. Nevertheless, the overall prognosis remains favorable when timely intervention is performed.

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Keywords

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