Norwood procedure

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The Norwood Procedure is a surgery performed on the heart. This procedure is most often performed to treat Hypoplastic Left Heart Syndrome, certain types of mitral atresia, or other conditions that result in single ventricle circulation.

Entry to the body cavity for the Norwood Procedure is gained by a vertical incision above the sternum. Separation of the sternum is necessary.

This surgery is complex and may vary slightly depending on the diagnosis and overall condition of the heart. The main pulmonary artery is separated from the left and right portions of the pulmonary artery and joined with the upper portion of the aorta. Widening of the pulmonary artery is often necessary, and may be accomplished by using the patient's existing biological tissue, or appropriate animal tissue. This allows the blood, oxygenated and deoxygenated, to be pumped to the body via the pulmonary valve.

Either a Sano Shunt or a modified Blalock-Taussig Shunt is then placed. Both are achieved with the use of a Gore-Tex tube. The Sano Shunt is performed by attaching the tube to the center of the left and right portions of the pulmonary artery. The other end of the tube is placed in the right ventricle, which allows blood to be pumped directly to the lungs. This tube, in effect, takes the place of the main pulmonary artery. The Blalock Taussig Shunt attaches the subclavian artery to the pulmonary artery. This method allows the blood pumped toward the lungs to bypass the heart altogether.

After this first step (switching the right ventricle in functional position of the absent left ventricle) the following two steps are the same as in the Fontan procedure.

Sources

• [2], Health Centers Online
• The Children's Heart Foundation (2004). It's My Heart. Children's Heart Foundation. ISBN 0-9711542-2-8.
• University of Michigan - HLHS - Stage 1 Norwood Procedure [3]

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