{
  "abstract": "Background and Clinical Significance: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) usually presents with heart failure at 2–3 months of age; cardiac arrest as the first manifestation is rare and often recognized only at autopsy. Case Presentation: A previously healthy girl collapsed at home at 65 days of age. After dispatcher-assisted parental resuscitation, the emergency team found asystole and achieved return of spontaneous circulation after approximately 4 min of professional resuscitation; the total low-flow time was not recorded. She was in cardiogenic shock (left ventricular ejection fraction 19.8%, high-sensitivity troponin T 2620 ng/L) with acute kidney injury and coagulopathy consistent with disseminated intravascular coagulation. Echocardiography showed a dilated right coronary artery and no flow from the aorta into the left coronary artery. Emergency repair on day 1 was followed by venoarterial extracorporeal membrane oxygenation (VA-ECMO) for 4 days and continuous renal replacement therapy. The Simpson ejection fraction reached about 50% by day 9, fell to 37–40% during respiratory deterioration and was 45–50% on day 27; mitral regurgitation, graded as massive during VA-ECMO, regressed to trace without valve surgery. She was discharged on day 42 with impaired diastolic indices; no formal neurological assessment was documented. Conclusions: ALCAPA should be considered in every infant with unexplained cardiac arrest, and post-resuscitation echocardiography should assess the coronary origins. Emergency repair with VA-ECMO can achieve survival to discharge despite multiorgan failure, but long-term cardiac and neurodevelopmental follow-up is required.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical and Experimental Pathology, Institute of Medical Sciences, Jan Kochanowski University, 25-516 Kielce, Poland",
    "2nd Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland",
    "Department of Gynecology and Obstetrics, Institute of Medical Sciences, Jan Kochanowski University, 25-516 Kielce, Poland"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Grzegorz Wróbel"
    },
    {
      "affs": [
        1
      ],
      "name": "Jakub Gruszka"
    },
    {
      "affs": [
        0
      ],
      "name": "Piotr Lewitowicz",
      "orcid": "0000-0002-5443-7975"
    },
    {
      "affs": [
        2
      ],
      "name": "Olga Adamczyk-Gruszka"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7z9tk94fszctt.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15218476",
  "fulltext_url": null,
  "id": "7z9tk94fszctt",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/21/8476",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/7z9tk94fszctt.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:21:07Z",
      "native_id": "10.3390/jcm15218476",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/21/8476"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Out-of-Hospital Cardiac Arrest as the First Manifestation of ALCAPA in a 9-Week-Old Infant: Survival to Discharge After Emergency Repair and VA-ECMO",
  "title_text": "Out-of-Hospital Cardiac Arrest as the First Manifestation of ALCAPA in a 9-Week-Old Infant: Survival to Discharge After Emergency Repair and VA-ECMO",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T00:21:04Z",
  "url": "https://research.draconitic.com/paper/7z9tk94fszctt",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}