Alternative Surgical Repair: Anomalous Left Coronary From the Pulmonary Artery Syndrome in Adulthood

Late presentation of an anomalous left coronary artery from the pulmonary artery (ALCAPA) syndrome is uncommon because of the low survival rates past infancy. Different operative procedures have been described, often combined with coronary bypass grafting. However, none of these approaches address the difficulty in dissecting out the aortic root and infundibulum because of collateral circulation, often dense in the elderly. We present the case of a 65-year-old man undergoing surgical repair of a rare ALCAPA syndrome. The approach alleviates navigational complexity in the setting of dense collateral circulation, reducing operating time and expediting recovery.