What Cardiothoracic Surgery at the Children’s Heart Center Is Known for
- Unifocalization: Repairing a Fourfold Defect All at Once
- Complex Repairs in Premature and Very Small Infants
- Heart Transplantation
- Innovative Research Programs
- Recent Publications
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.
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Since fixing the defect as soon as possible gives the infant the best chance of living normally, the Children’s Heart Center, led by Mohan Reddy, M.D., has developed techniques that allow congenital heart surgery even in extraordinarily small newborns, including successful repair in the smallest, youngest infant known. As a result of this experience, the Children’s Heart Center is among the world leaders in this demanding specialty.
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visit the program’s Web site and our Health Library.
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- Repairing the unborn heart. A Children’s Heart Center research team is investigating ways of diagnosing heart rhythm problems while the fetus is still in the womb and performing corrective surgeries before birth. The Center is the world’s leading site for research in this area, spearheaded by Doctors Reddy, Hanley, and Parry.
- Seeing the heart in depth. The Children’s Heart Center also leads the nation in the use of electronic beam three-dimensional CT (computerized tomography) scanners, which provide highly accurate images of the heart and major vessels. These images give surgeons a detailed view of the patient’s condition and allow thorough planning of the procedure in advance.
- Robots and surgery at a distance. Using a voice-activated robot equipped with a tiny fiber-optic camera that projects images on a computer screen, the surgeon can go directly to the problem area without stretching heart tissues or distorting delicate structures. Since robot surgery uses only three small incisions — one for the camera and two for surgical instruments — this approach minimizes pain and trauma. It also raises the possibility of surgery at a distance, in which a physician on a computer at the Children’s Heart Center performs a procedure on a child miles away in an operating room in his or her home community.
visit the publications by Children’s Heart Center surgeons page for a list of papers, book chapters, and abstracts published over the past five years.
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