Long-Term Outcomes after Surgical Repair of Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Difference in Terms of Age at Operation

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  • Cao Yuchen
    Department of Cardiovascular Surgery, Kanagawa Children’s Medical Center
  • Asou Toshihide
    Department of Cardiovascular Surgery, Kanagawa Children’s Medical Center
  • Asai Hidetsugu
    Department of Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
  • Niwano Haruki
    Department of Cardiovascular Surgery, Kanagawa Children’s Medical Center
  • Ikarashi Jin
    Department of Cardiovascular Surgery, Kanagawa Children’s Medical Center
  • Tachibana Tsuyoshi
    Department of Cardiovascular Surgery, Kanagawa Children’s Medical Center

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<p>Background: Establishment of a dual coronary arterial system for anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) results in good early and late outcomes. Left ventricular (LV) function often improves to normal late after ALCAPA repair. The impact of age at operation, nonetheless, remains unknown on the long-term outcomes and recovery process of LV function and dimension.</p><p>Methods: This retrospective review included 11 patients with ALCAPA who underwent surgery from 2003 to 2018. Patients were divided into two groups based on age at ALCAPA repair: group Y (n=5, age ≤1 year) and group O (n=6, age >1 year). Early, mid-term, and long-term outcomes and recovery of LV function and dimension were assessed. Median age at repair for groups Y and O was 4.3 and 94 months, respectively.</p><p>Results: No in-hospital or after-discharge deaths occurred in either of the groups. Median follow-up was 13.4 (1.8–16.4) years. Ejection fraction and fractional shortening in group Y took a longer interval (a median 5.8 months) before catching up with the level in group O, albeit with no statistical significance. No significant differences were found between the two groups in LV recovery after the mid-term follow-up.</p><p>Conclusions: We achieved excellent early and late outcomes with a low reintervention rate, regardless of age at ALCAPA repair. The LV function and dimension in group Y tended to need a few months longer to improve compared with those in group O.</p>

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