A Novel Aortic Reconstruction for Anomalous Left Coronary Arising From the Right Pulmonary Artery in Hypoplastic Left Heart Syndrome: Successful Surgical Treatment

Abstract

An anomalous left coronary arising from the pulmonary artery (ALCAPA) in hypoplastic left heart syndrome (HLHS) is a very rare congenital malformation. The Norwood procedure and simultaneous direct reimplantation of the left coronary artery (LCA) to the ascending aorta have been previously used for treatment of ALCAPA, although mortality was very high, because it is difficult to reimplant the LCA to the neoaortic root without distortion or tension. We chose the modified Norwood procedure without reimplantation of the LCA to the neoaortic root, and 4-month-old male infant survived the operation and waiting Fontan procedure.

Keywords: Anomalous left coronary arising from the pulmonary artery; Hypoplastic left heart syndrome; PA trunk-saving method; bronchomalacia; tracheomalacia.