Late intervention in an asymptomatic pediatric patient with anomalous left coronary artery

Area of Science:

• Pediatric Cardiology
• Congenital Heart Disease
• Cardiovascular Surgery

Background:

• Anomalous left coronary artery from the pulmonary artery (ALCAPA) typically presents in infancy with severe left ventricle (LV) dysfunction.
• Late diagnosis of ALCAPA is uncommon and presents unique clinical challenges.

Observation:

• A 5-year-old patient with late-diagnosed ALCAPA presented with mild LV dilatation and minimal mitral regurgitation.
• The patient had no significant LV dysfunction despite the anomalous coronary artery origin.

Findings:

• Surgical intervention involving revascularization was performed.
• Post-operative assessment showed no significant change in LV function or mitral regurgitation.

Implications:

• The optimal timing for surgical intervention in late-diagnosed ALCAPA remains debated.
• Early revascularization may potentially reverse ventricular and valvular dysfunction in these cases.
• This case highlights the variability in presentation and potential for favorable outcomes with timely intervention.