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J Thorac Cardiovasc Surg 2008;136:784-785
© 2008 The American Association for Thoracic Surgery

Brief Communication

Cardiac development after salvage partial left ventriculectomy in an infant with anomalous left coronary artery from the pulmonary artery

Stephen Westaby, PhD, MS, FETCS, FECS, FACCa,*, Nick Archer, MDb, Saul G. Myerson, MD, MRCP, FESCc

a Department of Cardiothoracic Surgery, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
b Department of Paediatric Cardiology, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
c Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom

Received for publication September 27, 2007; accepted for publication October 15, 2007.

* Address for reprints: Prof. Stephen Westaby, PhD, MS, FETCS, FECS, FACC, Consultant Cardiac Surgeon, Department of Cardiothoracic Surgery, John Radcliffe Hospital, Headley Way, Oxford OX4 3AU, United Kingdom. (Email: stephen.westaby@orh.nhs.uk).

The first 20% of the full text of this article appears below.

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is an unusual cause of heart failure in infancy.1Go At this stage, left coronary blood flow is reversed with steal into the pulmonary artery. Repeated episodes of myocardial ischemia or infarction cause globally impaired left ventricular function and may substantially increase the risk of surgical correction. In this report, we provide late follow-up on an infant with ALCAPA who, after coronary reimplantation, could not be separated from cardiopulmonary bypass without further intervention.

Clinical Summary

A 5-month-old girl had heart failure manifested by breathlessness and failure to thrive. Echocardiography demonstrated severely impaired left ventricular function and mitral regurgitation, and coronary angiography showed ALCAPA. An operation was performed to connect the left coronary ostium with the aorta using flaps derived from the pulmonary artery and aorta. These flaps . . . [Full Text of this Article]






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