Anomalous origin of the left coronary artery from the right pulmonary branch (ALCAPA): Case report

Abstract

Introduction: Anomalous origin of the left coronary artery, or ALCAPA syndrome, is a very rare congenital condition and a frequent cause of myocardial ischemia in the pediatric population. Reports indicate that the coronary artery usually arises from the left pulmonary sinus, followed by the right pulmonary sinus, then from the trunk, and much less frequently from the right pulmonary branch. We present the case of an 8-year-old girl with a left coronary artery arising from the right pulmonary branch, who underwent coronary reimplantation surgery with no major intraoperative complications, good postoperative results, and favorable evolution during outpatient follow-up. Origin from the right pulmonary branch is extremely rare, and there are no reports in our country of ALCAPA with this anatomical presentation. The presence of collateral coronaries allows patients to remain compensated with adequate LVEF. In the evaluation of dilated cardiomyopathy, assessment of coronary arteries is essential, since ALCAPA syndrome is a reversible and surgically correctable cause of dilated cardiomyopathy.