{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:45:30Z","timestamp":1789515930586,"version":"build-2803163510"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The number of diagnosed cases of anomalous origin of the left main coronary artery from the pulmonary artery (ALCAPA) in adults has increased substantially because of modern advances in non-invasive cardiac imaging. Here, we report successful surgical repair in an adult patient with ALCAPA complicated by severe mitral regurgitation (MR) and persistent atrial fibrillation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>ALCAPA syndrome was detected in a 65-year-old Asian woman with persistent atrial fibrillation by coronary computed tomographic angiography. An echocardiogram revealed severe MR caused by annular dilation, atrial enlargement, and posterior mitral leaflet tethering. In addition to ALCAPA repair, mitral valve repair and Cox-Maze IV cryoablation were performed. Mitral valve repair was performed using augmentation with an autologous pericardial patch in the posterior leaflet and ring annuloplasty.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Because the mechanism of MR with ALCAPA in an adult varies by comorbidity, mitral valve repair should be performed according to the valvular and subvalvular morphologies. It is essential to develop strategies that provide adequate myocardial protection during the surgical treatment of ALCAPA considering coronary steal and non-coronary collateral blood flow.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad340","type":"journal-article","created":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T00:04:19Z","timestamp":1689984259000},"source":"Crossref","is-referenced-by-count":4,"title":["Successful surgical repair of adult anomalous origin of the left main coronary artery from the pulmonary artery syndrome complicated by severe mitral regurgitation: a case report"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5776-1877","authenticated-orcid":false,"given":"Tetsuya","family":"Saito","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , 2-2 Yamadaoka, Suita, Osaka, Japan, 565-0871"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , 2-2 Yamadaoka, Suita, Osaka, Japan, 565-0871"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Toda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , 2-2 Yamadaoka, Suita, Osaka, Japan, 565-0871"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Miyagawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine , 2-2 Yamadaoka, Suita, Osaka, Japan, 565-0871"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"2023080309031062200_ytad340-B1","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1016\/S0046-8177(98)90277-5","article-title":"Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease","volume":"29","author":"Frescura","year":"1998","journal-title":"Hum Pathol"},{"key":"2023080309031062200_ytad340-B2","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/clc.20848","article-title":"Anomalous origin of the left coronary artery from the pulmonary artery in adults: a comprehensive review of 151 adult cases and a new diagnosis in a 53-year-old woman","volume":"34","author":"Yau","year":"2011","journal-title":"Clin Cardiol"},{"key":"2023080309031062200_ytad340-B3","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.jccase.2017.04.006","article-title":"An adult case of Bland-White-Garland syndrome with collaterals from giant right coronary artery and bronchial artery","volume":"16","author":"Tobita","year":"2017","journal-title":"J Cardiol Cases"},{"key":"2023080309031062200_ytad340-B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjcr\/ytaa318","article-title":"Late adult presentation of ALCAPA syndrome: need for a new clinical classification? 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