Norwood Procedure Stage 1 (Norwood)

LeRoy et al. (1996) state "the Norwood procedure is the first of three open heart surgeries. It is usually done within the first few weeks of life."

LeRoy et al. (1996) determine "the goal of this surgery is to rebuild the heart so it can pump enough blood to the lungs and the body."

The large main pulmonary artery and small aorta are fashioned together to make a new, larger aorta. There is a small tube (shunt) put in to connect the lung artery to the aorta. This shunt gives blood flow to the lungs. The wall that separates the top two heart chambers is removed (atrial septectomy). The narrowing of the aorta is opened.

 

 

Norwood Stage II (Glenn Shunt)

LeRoy et al. (1996) explain: "the Glenn Shunt procedure is the second open-heart surgery for babies with HLHS. It is usually done when the child is 4-12 months of age."

LeRoy et al. (1996) determine "the goal of this surgery is to reduce the workload for the right ventricle. It takes away the job of pumping blood to the lungs. Now, the right ventricle will only need to pump blood out to the body."

According to LeRoy et al. (1996), "the surgery includes the following steps:

  1. The main vein that brings blue blood back from the upper body, called the superior vena cava, is attached to the pulmonary arteries. Blood returning from the upper body goes directly to the lungs.
  2. The shunt placed during the Norwood procedure is taken out.
  3. A patch is placed at the top of the right atrium. This will make the next surgery easier to do."

 

 

Norwood Stage III (Fenestrated Fontan)

LeRoy et al. (1996) explain: "the Fenestrated Fontan procedure is the third open-heart surgery for babies with HLHS. It is usually done when the child is 12-24 months of age. A heart catheterization is done before the surgery to make sure it is safe to go ahead."

The blue blood from the lower part of the body is sent to the lungs. This is done using the inferior vena cava, the right atrial wall and/or artificial material (Gortex ®). A tube is placed through the top right part of the heart and connected to the right pulmonary artery branch. This rerouting of the blue blood allows it to enter the lungs without being pumped by the heart. The heart remains available to receive the red blood from the lungs and then pump it to the body. Some small holes are placed in the tube to allow the heart and body to adjust gradually to the new blood flow system. These small holes (fenestrations) close off on their own a few months after surgery. The surgery goal is to:

Norwood Stages I, II and III are done through a median sternotomy (chest) incision.

 

This page, unless otherwise noted, © Copyright 1996, Pritchett and Hull Associates, Inc. Atlanta, GA