Surgery of a Rare Case (ALCAPA / Bland-White-Garland Syndrome) Successfully Done in KIMS Cardiothoracic Surgery Department

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital coronary abnormality associated with early infant mortality and adult sudden death. As it predominantly presents in the first year of life, diagnosis in living adults is extremely rare. Late adult presentation of ALCAPA syndrome is hardly observed. Prior to modern diagnostics and surgical care, most cases were found in infants who died in the first year of life. However, survival into adult life without surgery is possible.

A 35-year old female patient presented with DOE and evaluated by Dr Anupam Jena, in Dept. of Cardiology and diagnosed as ALCAPA and referred to CTVS for surgery. The team of cardiac surgeons (Dr. A. Sharda, Dr Chandan Ku. Ray Mohapatra) and cardiac anaesthetists (Dr A. Badmali, Dr. Gyana R Mishra) performed the surgery successfully. The surgical details include : the abnormal coronary artery was detached from the pulmonary artery and connected to the aorta with interposition reverse saphenous vein graft. The pulmonary artery was closed with a pericardial patch. Intraoperative and postoperative period was uneventful. Patient was discharged on 6th post operative day.

The collaborative work by the Nursing Staff, other members of the Dept of CTVS, the infrastructure and the support of the KIMS administration led to the success of management of the unique case.