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Multifocal Electroretinograms
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Staged unifocalization revisited.

Yuki Nakamura1, Harold M Burkhart1

  • 1Division of Cardiovascular and Thoracic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.

Journal of Cardiac Surgery
|February 9, 2022
PubMed
Summary
This summary is machine-generated.

A staged lateral thoracotomy unifocalization approach offers a viable surgical option for pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries (PA/VSD/MAPCA). This method demonstrates high survival rates, proving essential when midline approaches are not feasible.

Keywords:
congenital heart disease

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Area of Science:

  • Pediatric Cardiac Surgery
  • Congenital Heart Disease Surgical Management
  • Thoracic Surgery Techniques

Background:

  • The staged thoracotomy unifocalization approach has been overshadowed by midline one-stage complete unifocalization over the past two decades.
  • Pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries (PA/VSD/MAPCA) present complex surgical challenges.

Purpose of the Study:

  • To evaluate the long-term outcomes of a "consistent" staged unifocalization approach via lateral thoracotomy for PA/VSD/MAPCA.
  • To assess the feasibility and efficacy of this surgical strategy in a consecutive patient cohort.

Main Methods:

  • Retrospective analysis of 39 consecutive patients with PA/VSD/MAPCA undergoing staged unifocalization through a lateral thoracotomy.
  • Data collected over a 30-year period (1989-present).

Main Results:

  • Definitive surgical repair was completed in 76.3% of patients.
  • An impressive overall survival rate of 96% at 20 years post-definitive repair was achieved.
  • The study period spanned from 1989 to the present, indicating long-term follow-up.

Conclusions:

  • The staged lateral thoracotomy unifocalization approach is a crucial alternative for PA/VSD/MAPCA, especially when anatomical variations preclude a midline approach.
  • Surgeons managing PA/VSD/MAPCA should maintain familiarity with the staged lateral thoracotomy unifocalization technique due to its effectiveness and high survival rates.