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Updated: Jan 20, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Mid-Term Functional Recovery after Surgical Correction of ALCAPA: A 16-Year Single-Center Experience
Mehmet B Beyter1, Eser Dogan1, Osman N Tuncer2
1Department of Pediatrics, Division of Pediatric Cardiology, Ege University School of Medicine, Izmir, Turkey.
Insights
Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is surgically correctable. Early repair in children significantly improves cardiac function and reduces mitral regurgitation within six months.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Cardiovascular Imaging
Background:
- Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart defect.
- It can lead to severe left ventricular dysfunction and mitral regurgitation in infants and children.
Purpose of the Study:
- To evaluate perioperative factors, short-term outcomes, and mid-term cardiac function after surgical repair of ALCAPA.
- To analyze the recovery of left ventricular ejection fraction (LVEF) and mitral regurgitation (MR) post-surgery.
Main Methods:
- Retrospective analysis of 23 pediatric patients surgically treated for ALCAPA between 2007 and 2023.
- Patients were stratified into infants (<1 year) and older children (>1 year).
- Echocardiographic parameters including LVEF and MR severity were assessed preoperatively and at 1 and 6 months postoperatively.
Main Results:
- Early mortality was 17.4%, with no late deaths. Infants presented with lower preoperative LVEF compared to older children (p=0.013).
- Survivors showed significant LVEF improvement by 1 month, normalizing by 6 months.
- Preoperative MR improved significantly, with only 2 patients having moderate MR and none severe MR at 6 months.
Conclusions:
- ALCAPA is a rare but treatable condition with early surgical intervention.
- Surgical repair of ALCAPA results in substantial recovery of ventricular function and regression of mitral regurgitation within six months post-operation.
Purpose:
This study aimed to assess perioperative features, early postoperative outcomes, and mid-term cardiac function in children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) undergoing surgical repair.
Methods:
A retrospective review of 23 patients treated surgically between 2007 and 2023 was conducted. Patients were categorized into infants (<1 year) and older patients (>1 year). Clinical, operative, and echocardiographic data were analyzed, including left ventricular ejection fraction (LVEF) and mitral regurgitation (MR). Follow-up evaluations were performed at 1 and 6 months postoperatively.
Results:
The median age at surgery was 9 months. Early mortality occurred in 17.4%, with no late deaths during follow-up. Preoperative LVEF was significantly lower in infants than in older patients (p = 0.013). Among 19 survivors, LVEF improved markedly by 1 month and normalized in all patients by 6 months. MR was present in 89.5% preoperatively, with 47.3% showing moderate to severe grades. At 6 months, MR improved in most cases, with only 2 patients exhibiting residual moderate regurgitation and no severe cases.
Conclusions:
ALCAPA is a rare but surgically correctable condition. Early surgical intervention leads to significant recovery of ventricular function and regression of MR within the first 6 postoperative months.
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