Postoperative Heart Failure in a Teen with Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: A Case Report Regarding Mechanisms

Abstract

A 16-year-old girl, who noted palpitations, and tightness in her chest, was referred to our hospital with a diagnosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). She underwent surgery using the Takeuchi method without difficulty, but she had respiratory distress and decreased cardiac function following surgery. Her symptoms improved rapidly after treatment with bisoprolol. Cardiac catheterization, performed to identify the cause of her symptoms, confirmed congestion of blood flow within the coronary vessels and regurgitation of right and left coronary blood flow into the ascending aorta. Although there are few reports discussing the cause of cardiac dysfunction in adults with ALCAPA, congestion of blood flow within the coronary vessels may cause postoperative cardiac dysfunction. Preoperative coronary sinus evaluation may identify a possible cause of postoperative cardiac dysfunction.