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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Total anomalous pulmonary venous connection beyond infancy.

Kandakure Pramod Reddy1, Ramodass Nagarajan, Usha Rani

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Surgical repair of total anomalous pulmonary venous connection in older children is safe and effective. This study shows acceptable outcomes for patients over infancy, with no early deaths or major complications.

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Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Surgery
  • Medical Technology

Background:

  • Total anomalous pulmonary venous connection (TAPVC) is typically repaired in infancy.
  • Delayed surgical correction beyond infancy presents unique challenges, particularly in developing nations.
  • Limited data exists on outcomes for older pediatric TAPVC patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of surgical correction for TAPVC in children presenting beyond infancy.
  • To assess postoperative outcomes, including morbidity and mortality, in this patient cohort.
  • To analyze the impact of delayed repair on pulmonary artery pressure.

Main Methods:

  • Retrospective review of 26 pediatric patients (age 1-16 years) undergoing TAPVC correction.
  • Diagnostic confirmation using transthoracic echocardiography.
  • Data collection on intensive care unit and hospital stay, postoperative complications, and follow-up outcomes.

Main Results:

  • No early deaths or major postoperative complications were observed.
  • Mean intensive care unit stay was 2.3 days and hospital stay was 9.2 days.
  • Significant reduction in pulmonary artery pressure was noted post-surgery, with follow-up ranging from 10-40 months.

Conclusions:

  • Surgical repair of TAPVC beyond infancy is a safe procedure with favorable outcomes.
  • Delayed correction can lead to significant improvements in pulmonary artery pressure.
  • This approach offers acceptable results for older pediatric TAPVC patients, even in resource-limited settings.