Repair of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) by sinus pouch technique

Background: ALCAPA is a rare disease. The sinus pouch technique reported in transposition of the great arteries has not been reported to be applied to ALCAPA, but it was a useful method. Case presentation: A five-month-old girl, weighing 5.3 kg, diagnosed ALCAPA underwent emergency surgery. The left coronary artery (LCA) originated from the posterior pulmonary artery (PA), and the left main trunk (LMT) was very short (1.5 mm), with moderate level of mitral valve regurgitation (MR). Because of the low height from the orifice to the pulmonary valve(Pv), it was necessary to avoid the tunneling technique due to concerns about adverse effects on the Pv. The sinus pouch technique was chosen because of its simplicity and low risk of stenosis due to coronary artery bending, especially in cases with short LMT. Conclusion: We report a case of infantile ALCAPA with good results using this technique.