Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly seen in 0.26% of all congenital heart defects. From 1978 to the present, we have encountered 11 such cases in patients ranging from 3 months to 60 years of age. A variety of procedures have been performed, such as ligation of the anomalous left coronary artery (n = 1), saphenous vein byp...