Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA)

The heart muscles need oxygenated red blood for proper functioning. This blood is supplied by small blood-carrying tubes called the coronary arteries, which arise from the aorta which is the main blood tube that carries red, oxygen-rich blood to the whole body . There are two coronary arteries. The one on the left, the left coronary artery is the main blood tube that supplies blood to the main pumping chamber on the left side of the heart. The right coronary artery arises from the aorta and supplies blood to the right sided pumping chamber. Sometimes, the main blood vessel to the heart muscle, the left coronary artery arises from the wrong blood tube. Instead of arising from the aorta which carries red oxygen-rich red blood, it arises from the blood tube carrying blue, oxygen poor blood to the lungs, called the pulmonary artery. This is called the anomalous origin of the left coronary artery from the pulmonary artery, short-form ALCAPA. 

This abnormality causes major issues as the heart muscle of the main pumping chamber is getting blue blood with much less oxygen than needed. When the heart muscle is not getting enough oxygen, it creates a “heart attack” like situation in babies. Babies suffer from heart pain which leads to bouts of incessant crying. Also, the heart muscles stop working/contracting normally and the heart function becomes affected. Once pumping capacity is affected significantly, heart failure sets in. 

Once diagnosed, an open heart surgery can fix this abnormality. The left coronary artery is re-connected to the correct blood tube, the aorta. This makes sure that the heart muscles get enough oxygen-rich red blood from the aorta through the newly implanted left coronary artery.

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​ALCAPA before and after surgical repair