Pediatric Heart Expert Forum
Unroofing surgery
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Unroofing surgery

My son has a True Right Single Coronary Artery ~ This forum has been so helpful in the past so I wanted to reach out to you again :)  I am meeting with the cardiologists soon regarding.  They have recommended unroofing. His left artery arises from the right and goes between the great arteries.  I know all these questions will be answered at the end of the week but I'm also wondering now so we can be prepared with questions for out consultation.  I was wondering if this is done the traditional way opening the ribs or minimally invasive?  He also needs a redo decompression and cervical fusion for his chairi and will be deciding which to do first.  Wondering what the recovery time is for the unroofing.  What can we expect?  Weeks or months?  I tried to look up unroofing and the descripton is hard to understand, can you explain in simple terms?  I want to put my list of questions together to bring and want to be sure I dont miss anything.  Would love any input you can share to understand what this procedure is and what the recovery is and what I should be asking the doctors.  Thank you so very much!! Robin
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Dear Robin,

A surgery as complex as this cannot be performed by a minimally invasive access for two reasons.  One, the access to the coronary arteries requires the ability to extensively see in and around the chest cavity to adequately view the course of the coronary arteries.  Two, since you son is not adult-sized, a minimally invasive approach would be working in an even smaller hole as compared to an adult-sized patient, making the risk even higher.  In order to get the best outcome in this case, a typical sternotomy would be appropriate, in which the breast bone (sternum) is divided.

Surgical recovery time depends on the success of the surgery and the quality of the surgical and post-operative team, obviously.  If things go well, his hospitalization should be less than one week.  Typical overall surgical recovery is less than two months, with the majority of healing finished by that time.
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