Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital cardiovascular anomaly that occurs in approximately 1 in 300,000 live births. This study aimed at identifying preoperative predictors of immediate postoperative outcomes. We conducted a retrospective, cross-sectional, single-center study and reviewed echocardiographic and hemodynamic data from all patients before and after surgical repair of ALCAPA at our center from January 2004 to February 2018. In all cases, the left coronary artery arose from the main pulmonary artery or a major branch. A total of 10 patients (age 1 month to 10 years, median 3 months) underwent ALCAPA surgical repair during the study period. No patients required a left ventricular assist device (LVAD) before surgery, but 4 patients (40%) received an LVAD after the surgery. The left ventricular ejection fraction (LVEF) improved in all patients following surgery. The utility of preoperative factors associated with pre- and post-procedure LVEF was investigated. LV dimension, as well as right coronary artery (RCA) and left coronary circumflex artery (LCX) Z scores were associated with a higher LVEF in the preoperative state. Patients with larger RCA, left ascending artery (LAD), and LCX Z scores also had a shorter duration of mechanical ventilation and ICU stay following surgery. Patients with a RCA Z score < 4 required implantation of an LVAD postoperatively. ALCAPA patients with larger RCA and LCX demonstrated a higher preoperative LVEF, while those with larger RCA, LAD, and LCX had superior postoperative hemodynamics and clinical outcomes.

左冠状动脉起源于肺动脉的异常起源 (ALCAPA) 是一种罕见的先天性心血管异常，大约每 300,000 名活产婴儿中就有 1 名发生。本研究旨在确定术后即刻结果的术前预测因素。我们进行了一项回顾性、横断面、单中心研究，回顾了 2004 年 1 月至 2018 年 2 月在我们中心进行 ALCAPA 手术修复前后所有患者的超声心动图和血流动力学数据。在所有病例中，左冠状动脉起源于主肺动脉或主要分支。研究期间共有 10 名患者（年龄 1 个月至 10 岁，中位数 3 个月）接受了 ALCAPA 手术修复。没有患者在手术前需要左心室辅助装置 (LVAD)，但 4 名患者 (40%) 在手术后接受了 LVAD。手术后所有患者的左心室射血分数（LVEF）都有所改善。研究了与术前和术后 LVEF 相关的术前因素的效用。LV 尺寸，以及右冠状动脉 (RCA) 和左冠状动脉回旋动脉 (LCX)Z评分与术前状态下较高的 LVEF 相关。具有较大 RCA、左升动脉 (LAD) 和 LCX Z评分的患者在手术后的机械通气时间和 ICU 停留时间也较短。RCA Z评分 < 4的患者需要在术后植入 LVAD。RCA 和 LCX 较大的 ALCAPA 患者术前 LVEF 较高，而 RCA、LAD 和 LCX 较大的患者术后血流动力学和临床结果较好。