Anomalous Origin of the Left Coronary Artery From the Right Pulmonary Artery: An Extremely Rare Cardiac Malformation

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Anomalous origin of the left coronary artery from the right pulmonary artery (ALCARPA) is an extremely rare cardiac malformation and has been reported in only a few cases worldwide. Illustrative imaging of this very rare malformation is still missing.We present ALCARPA in a 4-week-old male infant who presented with distress and severe cardiac failure (Fig 1). Anomalous origin of the left coronary artery from the right coronary artery is shown in Figure 1 (∗). Surgical correction with reimplantation of the left coronary artery into the coronary sinus of the aorta was performed with the button technique using cardiopulmonary bypass and deep hypothermia. Postoperative management consisted of transitory extracorporeal membrane oxygenation support for a total of 6 days. At 1 month after surgery, the patient is doing well with only moderate left ventricular impairment. Anomalous origin of the left coronary artery from the right pulmonary artery (ALCARPA) is an extremely rare cardiac malformation and has been reported in only a few cases worldwide. Illustrative imaging of this very rare malformation is still missing. We present ALCARPA in a 4-week-old male infant who presented with distress and severe cardiac failure (Fig 1). Anomalous origin of the left coronary artery from the right coronary artery is shown in Figure 1 (∗). Surgical correction with reimplantation of the left coronary artery into the coronary sinus of the aorta was performed with the button technique using cardiopulmonary bypass and deep hypothermia. Postoperative management consisted of transitory extracorporeal membrane oxygenation support for a total of 6 days. At 1 month after surgery, the patient is doing well with only moderate left ventricular impairment.