@Article{schd.2026.076648,
AUTHOR = {Jia Yuan, Yanxing Lv, Xinyuan Ding, Yunyi Zeng, Li Ma, Hang Yang, Lin Jiang, Kamil Bildebayev, Boiko Yuliya Nikolaevna, Na Zhou},
TITLE = {Analysis of Relevant Factors Associated with Postoperative Recovery after Anomalous Origin of the Left Coronary Artery from Pulmonary Artery Surgery in Children},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {21},
YEAR = {2026},
NUMBER = {1},
PAGES = {0--0},
URL = {http://www.techscience.com/schd/v21n1/66829},
ISSN = {3071-1738},
ABSTRACT = {<b>Backgorund:</b> Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly of coronary artery anatomy, usually diagnosed in infancy, but adults may also be affected by this deformity. <b>Objectives:</b> The aim of this study is to examine long-term outcomes in patients with ALCAPA and analyze the relevant factors influencing postoperative outcomes. <b>Methods:</b> The records of patients with ALCAPA admitted from January 2015 to December 2024 were retrospectively reviewed. Clinical data of the patients were retrieved from the records. The follow-up data included mortality rates and complications. Kaplan-Meier survival curves were used to analyze the occurrence of death and reoperation during the follow-up of patients with ALCAPA, and the log-rank test was used for comparisons between groups. A Cox regression model was used to analyze the risk factors for adverse events in patients with clinical indicators of an unfavorable prognosis. <b>Results:</b> 48 patients met the study criteria. Postoperative death or reoperation was defined as an unfavorable prognosis. Patients were divided into two groups: favorable prognosis (n = 41) and unfavorable prognosis (n = 7). The differences among the Kaplan–Meier survival curves for the different subgroups were statistically significant. Feeding difficulties (<i>p</i> < 0.001), preoperative left ventricular end-diastolic diameter (LVEDD) Z score (<i>p</i> = 0.049), preoperative mechanical ventilation (<i>p</i> < 0.001), preoperative vasoactive drugs (<i>p</i> < 0.001), ECMO (<i>p</i> < 0.001), and delayed sternal closure (<i>p</i> < 0.001) were associated with an unfavorable prognosis. Multivariate Cox proportional hazard analysis revealed that preoperative LVEF (HR: 0.711; 95% CI: 0.542–0.932; <i>p</i> = 0.013), CPB time (HR: 1.021; 95% CI: 1.003–1.04; <i>p</i> = 0.022) and length of stay (HR: 1.064; 95% CI: 1.015–1.116; <i>p</i> = 0.01) were associated with an unfavorable prognosis in patients, and age at surgery (HR: 1.092; 95% CI: 0.991–1.203; <i>p</i> = 0.077) was closely related to an unfavorable prognosis. <b>Conclusions:</b> A younger surgical age, a reduced preoperative LVEF, a longer CPB time, and a longer length of stay were associated with an unfavorable prognosis in this cohort.},
DOI = {10.32604/schd.2026.076648}
}