A small number of newborns suffer from a complex and potentially fatal congenital defect known as tetralogy of Fallot with pulmonary atresia and major aorto-pulmonary collaterals. In infants with this defect, the blood vessels that should connect the heart to the lungs instead connect the lungs to the aorta, and the heart itself has a hole in the wall separating its lower chambers (ventricles).
In the past, surgeons could repair this complex and life-threatening defect only with several separate surgeries, each of which required the chest to be opened and the heart stopped. Unifocalization – developed and pioneered by Children’s Heart Center Director Frank L. Hanley, M.D. – repairs the complete defect with only one surgery, in the majority of patients.
In unifocalization, the misdirected blood vessels are rerouted into a single vessel (or into the pulmonary artery if it is present), which is then attached to the right ventricle of the heart through a conduit called a homograft. This restores normal circulation from lungs to heart. Next, the hole in the ventricle wall is repaired.
Because unifocalization is complex, the procedure takes six to 10 hours, and is followed by hospitalization of up to 14 days.
The benefits of unifocalization to the patient are significant. The procedure decreases overall hospital time for the child, and it reduces the number of major surgeries, anesthesias, and incisions, sparing the child additional pain and trauma. In addition, this procedure makes it more likely that the heart can be repaired before the child’s condition worsens and makes surgery either more difficult or, worst of all, impossible.
Source: Lucile Packard Children’s hospital at Stanford
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