Brilliant advancements in pediatric medicine and surgery mean that more and more children are not only surviving, but growing up to become adults who are leading full lives. That also means that the need for ongoing care for adults with congenital heart defects is growing as well.
Our surgeons take an individualized approach to treating complex conditions that other facilities either treat in multiple surgeries (instead of combining multiple procedures into one), or may shy away from treating all together.Expand panels
Did you know? Cook Children's cardiothoracic surgical team performs an average of 400 complex surgeries every year.
- Repair of complex congenital heart defects, including corrected transposition of the great artery and heterotaxy syndromes
- Staged palliation of complex single ventricular heart defects such as hypoplastic left heart syndrome
- Heart valve repair
- Aortic translocation, also known as the Nikaidoh procedure
- Arrhythmia, pacemaker and defibrillator surgery
- Complex unifocalization
When a child is diagnosed with the rare combination of transposition of the great arteries, pulmonary stenosis and a ventricular septal defect, an aortic translocation or "the Nikaidoh procedure" is necessary.
With the Nikaidoh Procedure, the aorta is switched, along with the aortic valve, and placed in the pulmonary position. This avoids leaks of a faulty pulmonary valve on the right side. Additionally, it is necessary to mobilize the coronary arteries, as is done in the Arterial Switch Operation. The pulmonary root is divided at the level of the pulmonary valve, which is excised. The outlet septum is excised, thereby removing the superior margin of the VSD. The aortic root is transposed posteriorly so that it lies primarily over the left ventricle. The VSD is closed with a patch, which is anchored to the aortic root at its superior margin. The pulmonary artery is connected to the right ventriculotomy with an anterior patch of pericardium.
The procedure was developed by Hisashi Nikaidoh, M.D. in 1984 as a more effective alternative to the Rastelli procedure.
From 2011 to 2014, Cook Children's performed 10 of these procedures with 0% mortality, compared to 62 procedures performed nationally, as reported by the STS with a mortality rate of 3.2%.
This procedure repairs a complex and potentially fatal congenital defect known as tetralogy of Fallot with pulmonary atresia and major aorto-pulmonary collaterals in just one procedure. This procedure recreates the child's pulmonary arteries, making it more likely that the heart can be repaired before the child's condition worsens which can cause the surgery to be more difficult, or even impossible.
Cook Children's Heart Center is one of a few pediatric heart programs in the country to perform the unifocalization procedure, specifically on neonates and infants.
What we treat
Our cardiothoracic surgery team's services include the repair of complex congenital heart defects, such as:
- Hypoplastic left heart syndrome
- Transposition of the great arteries
- Single ventricle abnormalities
- Total anomalous pulmonary venous connection
- Tetralogy of Fallot
- Pulmonary Atresia with VSD and MAPCAs
- Double outlet right ventricle
- Truncus arteriosus
- Anomalous origin of the coronary arteries
- Corrected transposition of the great arteries
- Ebsteinâ€™s anomaly
- Atrioventricular canal defect
Our specialty care team
Hisashi Nikaidoh, MD
Phillip Burch, MD
Vincent K.H. Tam, MD
Vinod Sebastian, MD