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

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.