What Our Heart Surgeons at Stanford Medicine Children’s Health Are Known For

Unifocalization: Repairing a fourfold defect all at once

A small number of newborns suffer from a complex and potentially fatal congenital defect known as tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral arteries. 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). Our interactive 3-D animation helps you learn more about your child’s heart and unifocalization, a novel surgical technique, which we are number one in the world for performing.

In the past, heart surgeons could only repair this complex and life-threatening defect with several separate surgeries, each of which required the chest to be opened and the heart stopped. Unifocalization—developed and pioneered by Frank L. Hanley, MD, executive director of the Betty Irene Moore Children’s Heart Center—repairs the complete defect with only one surgery in the majority of patients.

How unifocalization works

  • In unifocalization, the blood vessels that are not directed properly 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 homograft (tissue that comes from a human). This restores normal circulation from lungs to heart. Next, the hole in the ventricle wall is repaired.
  • Because unifocalization is complex, the procedure takes approximatively six to 10 hours and is followed by hospitalization of up to 14 days.
  • The benefits of unifocalization to the patient are significant. If your child undergoes this surgery, know that the unifocalization procedure decreases overall hospitalization time for your child, and it reduces the number of major surgeries, anesthetics, and incisions, sparing your child additional pain and trauma. In addition, this procedure makes it more likely that the heart can be repaired before your child’s condition worsens and makes heart surgery either more difficult or, worst of all, impossible.
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Learn more about unifocalizaiton

View the difference between a healthy heart and one with tetralogy of Fallot with pulmonary atresia and how our surgeons treat it with unifocalization.