# Mid-Term Functional Recovery after Surgical Correction of ALCAPA: A 16-Year Single-Center Experience

## TL;DR

This study examines the mid-term recovery of children who underwent surgery for a rare heart condition called ALCAPA, showing significant improvement in heart function and reduced regurgitation within six months.

## Contribution

The study provides a 16-year single-center analysis of ALCAPA surgical outcomes, emphasizing functional recovery and mitral regurgitation improvement.

## Key findings

- Early mortality was 17.4%, with no late deaths observed during follow-up.
- Left ventricular ejection fraction (LVEF) improved significantly by one month and normalized by six months in all survivors.
- Mitral regurgitation improved in most patients, with only two cases of residual moderate regurgitation at six months.

## Abstract

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.

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.

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.

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.