Midline one-stage complete unifocalization early outcomes from a single center

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Disease Repair
• Surgical Innovation

Background:

• Ventricular septal defect (VSD), pulmonary atresia (PA), and major aortopulmonary collateral arteries (MAPCAs) present complex repair challenges.
• Single-stage complete unifocalization offers a potential solution for these complex congenital heart conditions.

Purpose of the Study:

• To evaluate the experience and outcomes of single-stage complete unifocalization with intraoperative flow study for VSD, PA, and MAPCAs.
• To assess the feasibility and efficacy of this combined surgical approach.

Main Methods:

• Retrospective chart review of patients undergoing single-stage midline unifocalization.
• Inclusion of intraoperative flow study as part of the surgical procedure.

Main Results:

• Twenty-two patients underwent the procedure, with a median age of 11 months.
• In-hospital mortality was 5%, and the estimated survival rate was 80% at 10 months.
• Only 36% of patients achieved total correction, with challenges noted in VSD closure and complete unifocalization.

Conclusions:

• Single-stage unifocalization is a feasible treatment for VSD, PA, and MAPCAs.
• The cohort experienced suboptimal outcomes regarding complete repair rates.
• Surgical technique, completeness of unifocalization, and flow study implementation were identified as critical factors influencing results.