{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:17:04Z","timestamp":1783516624679,"version":"3.55.0"},"reference-count":10,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":148,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA, or Bland\u2013White\u2013Garland syndrome) is a rare congenital anomaly associated with a high risk of ischaemic cardiomyopathy and sudden cardiac death. Non\u2010cardiac surgery in patients with uncorrected anomaly is exceedingly rare and standardised peri\u2010operative risk models are lacking. This case report highlights the complex physiological considerations and tailored anaesthetic management of a 13\u2010year\u2010old girl with uncorrected ALCAPA undergoing general anaesthesia for dental extractions. Pre\u2010operative echocardiography demonstrated left ventricular dilatation (52.2\u2009mm) with a preserved ejection fraction (68%) and mild mitral regurgitation. Cardiac magnetic resonance imaging revealed extensive subendocardial scarring and inducible stress perfusion defects, indicating ongoing ischaemic and arrhythmogenic risk. Following a multidisciplinary consensus, the procedure was performed under strict haemodynamic control. General anaesthesia was carefully titrated to maintain the balance between myocardial oxygen supply and demand, and to prevent the exacerbation of coronary steal, with advanced ischaemia monitoring and immediate defibrillator availability. The patient remained haemodynamically stable throughout the peri\u2010operative period. This case demonstrates that by integrating detailed anatomic and functional imaging data, anaesthetic strategies can be precisely tailored to manage the severe physiological vulnerabilities of patients with uncorrected ALCAPA.<\/jats:p>","DOI":"10.1002\/anr3.70069","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T06:24:48Z","timestamp":1780122288000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anaesthetic management of an adolescent with untreated anomalous origin of the left coronary artery from the pulmonary artery (\n                    <scp>ALCAPA<\/scp>\n                    ) undergoing non\u2010cardiac surgery"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-9513","authenticated-orcid":false,"given":"J. Y. M.","family":"Tong","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Peri\u2010operative Medicine Hong Kong Children's Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Har","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Prince of Wales Hospital  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-025-03548-x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.292085059"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytaa318"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2011.01.017"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.219156"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.oa.25-00181"},{"key":"e_1_2_5_8_1","first-page":"284","article-title":"Perioperative outcome and long\u2010term mortality for heart failure patients undergoing intermediate\u2010 and high\u2010risk noncardiac surgery: impact of left ventricular ejection fraction","volume":"15","author":"Healy KO","year":"2010","journal-title":"Congest Heart Fail"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19031554"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.05.031"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-16-3"}],"container-title":["Anaesthesia Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.70069","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/anr3.70069","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/anr3.70069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T12:38:15Z","timestamp":1783514295000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1002\/anr3.70069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/anr3.70069"],"URL":"https:\/\/doi.org\/10.1002\/anr3.70069","archive":["Portico"],"relation":{},"ISSN":["2637-3726","2637-3726"],"issn-type":[{"value":"2637-3726","type":"print"},{"value":"2637-3726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-05-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70069"}}