Enhancing Unifocalization With Saline Inflation Testing and a Handmade Valved Conduit in Major Aortopulmonary Collateral Arteries.

Unifocalization of pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries is technically challenging because of the differing embryological development of the central pulmonary artery, major aortopulmonary collateral arteries, and parenchymal pulmonary arteries. We performed unifocalization using a saline "inflation test" not only to prevent kinking of the vessels, but also to identify differences in extensibility to intergrade uniform vessels. Moreover, right ventricular outflow tract reconstruction using a handmade valved conduit was performed to facilitate easy access to the catheter intervention to maintain a uniform vascular network. This approach offers a potential solution for the treatment of complex conditions.