Left ventricular aneurysmectomy in a child. Treatment of anomalous left coronary artery

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease
• Cardiac Surgery

Background:

• Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect.
• ALCAPA can lead to severe left ventricular dysfunction and dilation, including aneurysm formation.
• Ventricular aneurysms in pediatric patients with ALCAPA are uncommon but pose significant surgical challenges.

Purpose of the Study:

• To describe a case of ALCAPA with massive left ventricular aneurysm in a young child.
• To detail the surgical management of this complex condition.
• To evaluate the applicability of established adult surgical principles to pediatric ventricular aneurysm resection.

Main Methods:

• Surgical ligation of the anomalous left coronary artery originating from the pulmonary artery.
• Excision of the left ventricular aneurysm (ventricular aneurysmectomy).
• Coronary artery bypass grafting using a saphenous vein graft to the left anterior descending artery.

Main Results:

• Successful surgical correction of ALCAPA and left ventricular aneurysm.
• The patient tolerated the complex procedure well.
• Postoperative recovery was uneventful, with improved ventricular function.

Conclusions:

• Surgical principles for ventricular aneurysm resection in adults are applicable and effective in pediatric patients with ALCAPA.
• Early diagnosis and surgical intervention are crucial for managing ALCAPA with ventricular aneurysm.
• This case highlights successful complex cardiac reconstruction in a pediatric patient.