norwood procedures


Summary: A set of surgical procedures performed to establish sufficient outflow to the systemic circulation in individuals with univentricular congenital heart malformations, such as HYPOPLASTIC LEFT HEART SYNDROME, and MITRAL VALVE atresia, associated with systemic outflow obstruction. Follow-on surgeries may be performed and consist of a HEMI-FONTAN PROCEDURE as the stage 2 Norwood procedure and a FONTAN PROCEDURE as the stage 3 Norwood procedure.

Top Publications

  1. Gulgun M, Slack M. Stent Placement in a Neonate with Sano Modification of the Norwood using Semi-Elective Extracorporeal Membrane Oxygenation. Arq Bras Cardiol. 2016;107:600-604 pubmed publisher
    ..The use of ECMO as a bridge to recovery might be a feasible and reasonably safe adjunctive approach in the treatment of complications in selective case of neonates having undergone the Norwood Sano procedure. ..
  2. Martin B, Kaestner M, Peng M, Ross D, Urschel S, West L, et al. Glutaraldehyde Treatment of Allografts and Aortic Outcomes Post-Norwood: Challenging Surgical Decision. Ann Thorac Surg. 2017;104:1395-1401 pubmed publisher
    ..The objective was to determine whether GA treatment of allografts used in Norwood procedures increases the risk of recurrent aortic obstruction...
  3. Faria R, Pacheco J, Oliveira I, Vidal J, Rodrigues A, Costa A, et al. Modified Hybrid Procedure in Hypoplastic Left Heart Syndrome: Initial Experience of a Center in Northeastern Brazil. Braz J Cardiovasc Surg. 2017;32:210-214 pubmed publisher
    ..In this series, the initial experience with the modified off-pump hybrid procedure showed to be safe, allowing a low early mortality rate among children presenting HLHS. ..
  4. Hanke S, Joy B, Riddle E, Ravishankar C, Peterson L, King E, et al. Risk Factors for Unanticipated Readmissions During the Interstage: A Report From the National Pediatric Cardiology Quality Improvement Collaborative. Semin Thorac Cardiovasc Surg. 2016;28:803-814 pubmed publisher
    ..Unanticipated readmissions are common during the interstage period with notable center variation. However, these readmissions are short and are rarely in response to major adverse events. ..
  5. Oberhuber R, Huemer S, Mair R, Sames Dolzer E, Kreuzer M, Tulzer G. Cognitive Development of School-Age Hypoplastic Left Heart Syndrome Survivors: A Single Center Study. Pediatr Cardiol. 2017;38:1089-1096 pubmed publisher
  6. Kirkpatrick E, Steltzer J, Simpson P, Pan A, Dragulescu A, Falkensammer C, et al. Pulmonary Vein Doppler Patterns in Infants with Single Right Ventricle Anomalies After Initial Staged Palliations. Pediatr Cardiol. 2017;38:1288-1295 pubmed publisher
    ..This study describes normative values and variations in PVF for infants with a single RV from shunt-dependent pulmonary blood flow to cavopulmonary blood flow. ..
  7. Pourmoghadam K, DeCampli W, Ruzmetov M, Kosko J, Kishawi S, O Brien M, et al. Recurrent Laryngeal Nerve Injury and Swallowing Dysfunction in Neonatal Aortic Arch Repair. Ann Thorac Surg. 2017;104:1611-1618 pubmed publisher
    ..In the Norwood population, length of stay is not associated with presence or absence of VCD. More than 70% of patients in each group who had direct flexible laryngoscopy follow-up recovered vocal cord function. ..
  8. Meza J, Hickey E, Blackstone E, Jaquiss R, Anderson B, Williams W, et al. The Optimal Timing of Stage 2 Palliation for Hypoplastic Left Heart Syndrome: An Analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Data Set. Circulation. 2017;136:1737-1748 pubmed publisher
    ..Early S2P did not rescue patients with greater risk factor burdens. Instead, referral for heart transplantation may offer their best chance at long-term survival. URL: Unique identifier: NCT00115934. ..
  9. Bryant R, Wallen W, Rizwan R, Morales D. Modified Aortic Uncrossing Procedure: A Novel Approach for Norwood Palliation of Complex Univentricular Congenital Heart Disease With a Circumflex Aorta. World J Pediatr Congenit Heart Surg. 2017;8:507-510 pubmed publisher
    ..We report such a case and describe our approach to its surgical management. ..

More Information


  1. Gazit A, Petrucci O, Manning P, Shepard M, Baltagi S, Simpson K, et al. A Novel Surgical Approach to Mechanical Circulatory Support in Univentricular Infants. Ann Thorac Surg. 2017;104:1630-1636 pubmed publisher
    ..This approach overcomes several major challenges encountered in these patients, such as high flow requirement and stability of the cannulae, and allows extubation, rehabilitation, and at times, myocardial recovery. ..
  2. Texter K, Davis J, Phelps C, Cheatham S, Cheatham J, Galantowicz M, et al. Building a comprehensive team for the longitudinal care of single ventricle heart defects: Building blocks and initial results. Congenit Heart Dis. 2017;12:403-410 pubmed publisher
    ..This article describes the process of building a successful Single Ventricle team, our initial results, and lessons learned. Additional study is ongoing to demonstrate the effects of these interventions on patient outcomes. ..
  3. Hittinger S, Bandisode V, Chowdhury S, Kavarana M. Aortic Dissection After the Hybrid Stage 1 Procedure: Diagnosis and Management Strategy. Ann Thorac Surg. 2017;104:e275-e277 pubmed publisher
    ..Aortic dissection after hybrid Norwood palliation is a rare but ominous complication that has not been reported. ..
  4. Shinkawa T, Holloway J, Tang X, Gossett J, Imamura M. Experience Using Kaolin-Impregnated Sponge to Minimize Perioperative Bleeding in Norwood Operation. World J Pediatr Congenit Heart Surg. 2017;8:475-479 pubmed publisher
    ..02 and .005). Use of kaolin-impregnated hemostatic sponge was associated with reduced blood product use and perioperative bleeding complications in Norwood operation at a single institution. ..
  5. Gładki M, Składzień T, Żurek R, Broniatowska E, Wójcik E, Skalski J. Effect of acid-base balance on postoperative course in children with hypoplastic left heart syndrome after the modified Norwood procedure. Medicine (Baltimore). 2017;96:e7739 pubmed publisher