Mid-Term Functional Recovery after Surgical Correction of ALCAPA: A 16-Year Single-Center Experience

PURPOSE: This study aimed to assess perioperative features, early postoperative outcomes, and mid-term cardiac function in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) undergoing surgical repair. METHODS: A retrospective review of 23 patients treated surgically between 2007 and 2023 was conducted. Patients were categorized into infants (1 year). Clinical, operative, and echocardiographic data were analyzed, including left ventricular ejection fraction (LVEF) and mitral regurgitation (MR). Follow-up evaluations were performed at 1 and 6 months postoperatively. RESULTS: The median age at surgery was 9 months. Early mortality occurred in 17.4%, with no late deaths during follow-up. Preoperative LVEF was significantly lower in infants than in older patients (p = 0.013). Among 19 survivors, LVEF improved markedly by 1 month and normalized in all patients by 6 months. MR was present in 89.5% preoperatively, with 47.3% showing moderate to severe grades. At 6 months, MR improved in most cases, with only 2 patients exhibiting residual moderate regurgitation and no severe cases. CONCLUSIONS: ALCAPA is a rare but surgically correctable condition. Early surgical intervention leads to significant recovery of ventricular function and regression of MR within the first 6 postoperative months.