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Anomalous Left Coronary Artery Arising from the Pulmonary Artery (ALCAPA)

Anomalous left coronary artery arising from the pulmonary artery (ALCAPA) is a type of congenital heart disease. Congenital means that a baby is born with the condition.

A rare condition, only about 1 in 300,000 babies are born with ALCAPA. It can be difficult to diagnose.

As a top-ranked pediatric heart center, Lurie Children’s has expertise in both diagnosis and treatment of ALCAPA. We’re able to perform any heart surgery your child may need.


What is ALCAPA?

As its name suggests, ALCAPA is a problem with the left coronary artery. In a healthy heart, this artery comes from the aorta. With ALCAPA, the left coronary artery instead comes from the pulmonary artery.

This causes several problems.

First, having the arteries connected this way means oxygenated blood isn’t flowing to the heart muscle the way it should. This can lead to a heart attack. Without oxygenated blood, the heart becomes damaged. Ultimately, a damaged heart can’t do its job of pumping blood throughout the body. This can lead to heart failure.

A child with ALCAPA needs treatment immediately.

What are Symptoms of ALCAPA?

We aren’t able to diagnose ALCAPA in-utero. But a baby born with this condition will have symptoms in the first few months of life.

The main symptoms are:

  • Breathing issues: Rapid breathing, often with pale skin, sometimes combined with a cough.
  • Feeding issues: Poor feeding, sweating during feeds, or crying during feeds without any obvious reason.
  • Acting in a way that suggests pain or distress: This often presents as excessive crying and/or fever.

How We Diagnose and Treat ALCAPA

Our pediatric cardiologists have expertise in interpreting the most common tests that check for ALCAPA, including:

  • Electrocardiogram (ECG): A non-invasive test we use to measure the electrical activity of the heart. Learn about electrocardiograms.
  • Echocardiography: An ultrasound that lets us see the structure of the heart and how blood is flowing inside the heart. Understand how echocardiograms work.

Many times, we need to do more testing to make a definitive diagnosis. One of these tests, cardiac catheterization, requires anesthesia and has some risks for infants.

Because we have a renowned advanced cardiac imaging program, we can often use cardiac computed tomography (CT) or cardiac MRI to make the diagnosis. These less invasive tests help us avoid cardiac catheterization. This matters for a condition like ALCAPA that can be tricky to diagnose.

A baby with ALCAPA needs surgery soon after diagnosis to correct the condition. Our cardiac surgeons have experience with this surgery.

Why Choose Lurie Children’s?

Any time your child needs surgery, it’s frightening. You may have little time to process everything. Know that at Lurie Children’s, we’re always ready for your family, and we:

  • Treat the most complex cases: As a destination heart center, we offer second opinions and one-stop care.
  • Have surgical outcomes on par with the best in the nation: For surgeries and other pediatric heart procedures, our outcomes are among the best in the nation.
  • Collaborate with all specialties: Close consultation with radiology is especially important in diagnosing and treating ALCAPA.
  • Offer complete care, including heart transplant: Some children will need care above and beyond, including heart transplant. We are one of the top transplant centers in the country.

Long-Term Effects of ALCAPA

With life-saving treatment such as surgery, babies with ALCAPA can recover and live a healthy life. However, they will need to see a congenital heart specialist, even into adulthood. Lurie Children’s has an Adult Congenital Heart Disease program for kids who age out of their pediatric program.

If a baby’s heart is severely damaged by ALCAPA, we may put them on mechanical support after surgery. This includes:

  • Extracorporeal membrane oxygenator (ECMO): ECMO is a type of support that allows a child’s heart and lungs to rest, recover and get stronger. Learn about pediatric ECMO at Lurie Children’s.
  • Ventricular assist device (VAD): A VAD can do the work of the heart while a child waits for a transplant. We also use it to help a child’s heart recover. Learn how Lurie Children’s uses VAD as treatment.

Occasionally, a child’s heart muscle function does not improve and they need more complex care. We can help these children as well, including performing heart transplant and caring for them throughout adulthood.

Heart Center Family Resource Guide

To help prepare families for their care with Lurie Children's Heart Center, we have compiled a list of resources about treatment and recovery. Learn how to get ready for an inpatient stay or outpatient visit, and read about our support services for patients and families.

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