How is anomalous left coronary artery from the pulmonary artery (ALCAPA) treated?

Updated: Aug 10, 2020
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: Syamasundar Rao Patnana, MD  more...
  • Print
Answer

The severity of symptoms in patients with anomalous left coronary artery from the pulmonary artery (ALCAPA) at presentation determines whether the patient is admitted to an intensive care unit (ICU) for aggressive medical management of congestive heart failure (CHF) before surgical revascularization.

Initial postoperative management occurs in a pediatric ICU until the patient is extubated and no longer requires intravenous inotropic support or antiarrhythmics.

Following surgical revascularization, postoperative care includes the short-term use of inotropes (eg, oral digoxin), diuretics, and afterload reduction medication (eg, angiotensin converting enzyme [ACE] inhibitors) to improve cardiac output and to eliminate the preoperative symptoms of CHF.

Monitor continuously during the immediate postoperative period, because there is a risk, although unusual, of cardiac dysrhythmia secondary to preoperative myocardial ischemia or infarction.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!