Atypical presentation of ALCAPA in a young boy: a case report
1Department of Cardiovascular Surgery, West China Hospital Sichuan University, Chengdu, Sichuan, China.
Cardiology in the Young
|September 29, 2025
Summary
Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a rare defect. Pulmonary hypertension masked ALCAPA in a child, posing diagnostic challenges, but surgery was successful.
Area of Science:
- Pediatric Cardiology
- Congenital Cardiovascular Defects
- Medical Imaging
Background:
- Anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect in children.
- Diagnosis typically involves visualizing the anomalous origin or retrograde flow via angiography or echocardiography.
- Pulmonary hypertension can mask ALCAPA, presenting diagnostic challenges.
Purpose of the Study:
- To highlight the diagnostic challenges of ALCAPA in young children.
- To present a case where pulmonary hypertension masked the anomalous coronary artery origin.
- To discuss the management and outcome of a surgically corrected ALCAPA case.
Main Methods:
- Case report of a pediatric patient with ALCAPA.
- Diagnostic imaging including echocardiography and angiography.
- Surgical intervention involving coronary artery reimplantation and mitral valve repair.
Main Results:
- Echocardiography showed atypical features due to masked anomalous origin by pulmonary hypertension.
- Severe mitral regurgitation was identified as a cause of secondary pulmonary hypertension.
- Successful surgical correction resulted in significant symptom resolution.
Conclusions:
- ALCAPA diagnosis can be challenging in the presence of pulmonary hypertension.
- Severe mitral regurgitation can lead to pulmonary hypertension and atypical ALCAPA presentation.
- Surgical repair of ALCAPA with mitral valve repair is effective in resolving symptoms.
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