Background. The aim of this study is to verify the result of the surgical treatment of ALCAPA and to identify the postoperative changes of left ventricular dimensions and mitral regurgitation (MR). Methods. Fifteen patients operated on since 1985 were included in the study and medical records were reviewed retrospectively. After 1998 six patients were operaeted on by the established surgical strategies; 1) Dual perfusion and dual cardioplegic solution delivery through ascending aorta and main pulmonary artery during cardiopulmonary bypass, 2) Coronary transfer was done by rolled conduits made of pulmonary artery wall flap, and 3) Additional mitral valvular procedure was not performed. Results. The median age of study group was 6 months (1 month to 34 years) and nine of them (75%) were infants. The operative methods were left sunclavian artery to left coronary artery anastomosis in 1, simple ligation in 2, Takeuchi operation in 2, and coronary reimplantation in 10 pateints. The mean follow up period was 5.5