Anomalous Left Coronary Artery from the Pulmonary Artery (ALCAPA)

  • A congenital coronary artery anomaly in which the left coronary artery arises from the pulmonary artery rather than its usual origin from the aorta. This condition is one cause of poor cardiac function in infancy.

    For in-depth visual and audio information on this condition, visit the Boston Children's Hospital Multimedia Library.

    ALCAPA is a very rare heart defect that occurs as a result of the left coronary artery forming abnormally. Instead of connecting to the aorta, as in a normal heart, it connects to the pulmonary artery.

    • stands for Anomalous Left Coronary Artery from the Pulmonary Artery
    • very rare
    • surgery is needed to correct it
    • without surgery, most babies don’t survive their first year
    • with timely surgery, most babies do well and live a normal life

    Contact Us

    Heart Center
    Boston Children's Hospital

    300 Longwood Avenue
    Boston, MA 02115
    617-355-4278

  • What is ALCAPA?

    ALCAPA stands for Anomalous Left Coronary Artery from the Pulmonary Artery. It is a very rare heart defect where the left coronary artery forms abnormally. Instead of connecting to the aorta, as in a normal heart, it connects to the pulmonary artery.

    Why is ALCAPA a problem?

    In a normal heart, the left coronary artery starts in the aorta, the major blood vessel that takes oxygen-rich blood from the heart to the rest of the body.

    In children with ALCAPA, the left coronary artery starts at the pulmonary artery and carries oxygen-poor blood to the left side of the heart. When the heart doesn’t get enough oxygen, it can weaken or die.

    This is what happens during a heart attack. The damaged heart muscle cannot pump effectively, leading to heart failure.

    What are the symptoms of ALCAPA?

    Symptoms of ALCAPA in an infant include:

  • What tests are done to confirm ALCAPA?

    If a doctor thinks your child has ALCAPA, he may order tests such as:

    At Boston Children’s Hospital, the Catheterization Program is one of the largest and most experienced in the country, and performs more than 1,600 cardiac catheterizations each year.

    Boston Children’s is also a leader in advanced cardiac imaging. The Division of Non-Invasive Cardiac Imaging at Boston Children’s is staffed by more than 20 pediatric cardiologists who specialize in echocardiography and cardiac MRI.

    How is ALCAPA treated?

    To correct a congenital heart defect, your child needs surgery as soon as possible. The goal of surgery is to connect the anomalous left coronary artery with the aorta. If the mitral valve—which regulates blood flow between the chambers on the left side of the heart—is also damaged, your child may need surgery to repair or replace the valve. In some cases, if your baby’s heart is badly damaged, a heart transplant may be needed.

    With timely treatment, most babies do very well after surgery and can expect to live a normal life. However, your child will need routine follow-ups with a heart specialist.

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