Sealing the Gap: Successful Transcatheter Device Closure of Baffle Leak After ALCAPA Repair in an Infant – A Case Report

Abstract Introduction Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare and serious congenital coronary anomaly leading to significant myocardial ischemia and high mortality if untreated. The Takeuchi repair is an alternative treatment method, although it carries the risk of baffle leaks, a common complication. Case We present a seven-month-old girl with decompensated heart failure and severe left ventricular (LV) dysfunction, diagnosed with Lateral Sinus ALCAPA. Following the Takeuchi procedure and subsequent ECMO support, she developed a baffle leak, which was successfully treated using percutaneous transcatheter closure. Discussion Baffle leaks are a common complication post-Takeuchi repair of ALCAPA. Early identification and management are crucial. Percutaneous transcatheter closure offers a minimally invasive alternative to surgery for treating baffle leaks. To the best of our knowledge, this is the first documented instance of trans-catheter closure for a baffle leak following Takeuchi repair in an infant.