Transpulmonary artery correction of anomalous origin of the left coronary artery by saphenous vein graft

A transpulmonary saphenous vein graft was used to repair an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Postoperative cardiac catheterization revealed correction of the previous systemic arterial to venous shunt and a patent intrapulmonary artery conduit. The patient has experienced substantial symptomatic and functional improvement from the operation despite development of mild pulmonary outflow obstruction. Saphenous vein transpulmonary artery correction for ALCAPA offers an alternative surgical approach and may be the procedure of choice when anatomy or prior surgery preclude the more standard modes of revascularization.