| Norwood procedure | |
|---|---|
| Intervention | |
Diagram of a healthy heart and one suffering from Hypoplastic left heart syndrome. In the heart on the right, note the near absence of the left ventricle, which normally provides systemic circulation. In the Norwood procedure, blood flow from the right ventricle is rerouted to serve this function, which means that an alternative source of pulmonary circulation must be provided. |
|
| ICD-9-CM | 35.8 |
The Norwood Procedure is a surgery performed on the heart, the first successful use of the procedure was reported by Norwood and colleagues in 1981.[1][2]
Cardiopulmonary bypass is required.[3]
Contents |
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.
In these conditions, the most urgent problem is that the heart is unable to pump blood to the systemic circulation (i.e. to the body). The goal of the Norwood procedure is to connect the single ventricle to the systemic circulation. To accomplish this, blood flow to the lungs is disrupted, and therefore an alternative path must be created to supply the lungs.
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 surgery on the heart can be divided into two main steps.[4]
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, a mixture of oxygenated and deoxygenated, to be pumped to the body via the pulmonary valve.
Since the remainder of the pulmonary artery is now disconnected from the heart, one of a few techniques must be used to supply blood to the lungs:
After this first step (switching the right ventricle in functional position of the absent left ventricle) children generally proceed down the path to a Fontan procedure.
|
||||||||||||||||||||||||||||||||||