Statistical analysis Statistical analyses were performed using Wizard Pro 1.9.13 (Evan Miller, Chicago, Illinois, United States). Categorical variables were expressed as count (n) and percentages. Continuous variables were expressed as mean (SD) or median (minimum-maximum), depending on the distribution. Normality of the distribution was tested using the Shapiro-Wilk test. The paired t test and Wilcoxon signed-rank test were used for repeated measures, while the t test and the Mann-Whitney test were used for other cases. For multiple comparisons, proper analysis of variance or the Friedman test was used. Categorical data were compared using the χ 2 , McNemar, and Stuart-Maxwell tests for assessing changes over time. A P value of less than 0.05 was considered significant. Results and discussion Detailed preoperative characteristics are summarized in Supplementary material, Table S1.

BackgroundAnomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rare congenital heart disease. Retrograde flow from the right coronary artery (RCA) through natural collaterals to the low-pressure main pulmonary artery causes extensive ischemia. Limited data concerning the extent of permanent myocardial damage and functional recovery after surgical repair in the long-term follow-up is available.AimDetermination of the incidence of incipient myocardial dysfunction in ALCAPA patients in the long-term observation using tissue Doppler and speckle tracking echocardiography.Methods and resultsEighteen ALCAPA patients after surgical repair (at median age of 7 months, range 3–167) underwent echocardiographic examination after (median) 17 years. All but 4 patients in NYHA class II presented well at follow-up. No narrowing in proximal LCA was detected in color Doppler. The initial (pre-surgical) left ventricular (LV) ejection fraction of 33±17% almost normalized to 55±6%, but was lower than in the age, sex and body surface area matched control group: 62±5% (p<0.001). At follow-up, LV global longitudinal strain (LS): -15.8±3.3% vs -21.9±1.7%; right ventricular LS: -20.6±3.9% vs -24.9±4.6%; left atrial LS: 27.7±4.3% vs 41.0±11.5%; right atrial LS: 26.8±7.4% vs 44.0±7.9% and early pulsed wave to tissue Doppler mitral filling ratio (E/E’): 8.1±2.6 vs 5.8±1.3 were impaired in the ALCAPA population in comparison to the control group (p<0.01 for all comparisons). LV radial and circumferential strain did not differ between groups. Mean LS in the ALCAPA patients in the RCA region was -19.0±4.4%, while in the LCA region -13.8±7.3% (p<0.00001).ConclusionsDespite good clinical condition and normalized LV ejection fraction in ALCAPA patients after surgical repair in the long-term follow-up, the diastolic and longitudinal systolic function of all cardiac chambers remained impaired, especially in the LCA region. Lifelong surveillance of repaired ALCAPA patients is needed.

Przerost prawej komory serca jest rzadką patologią u noworodków. Do znanych przyczyn przerostu mięśnia sercowego u płodu należą: kardiomiopatia przerostowa, wady wrodzone serca, cukrzyca ciążowa oraz przedwczesne zamknięcie przewodu tętniczego. W pracy przedstawiono przypadek noworodka z przejściowym znacznym przerostem prawej komory serca o nieustalonej przyczynie.