Diagram of a healthy heart and one with Hypoplastic left heart syndrome. In the heart on the right, note the near absence of the left ventricle, which normally provides systemic circulation. Following the three-stage palliation (Norwood, Glenn or hemi-Fontan, then Fontan), 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
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The Norwood procedure is the first of three surgeries intended to create a new functional systemic circuit in patients with hypoplastic left heart syndrome (HLHS) and other complex heart defects with single ventricle physiology.[1] The first successful Norwood procedure involving the use of a cardiopulmonary bypass was reported by Dr. William Imon Norwood, Jr. and colleagues in 1981.[2][3]
Variations of Norwood procedure, or Stage 1 palliation, have been proposed and adopted over the last 30 years; however, the key steps have remain unchanged. In order to utilize the right ventricle as the main blood pumping mechanism into the systemic and pulmonary circulation, a connection between left and right atria is established via atrial septectomy. Next a connection between the right ventricle and aorta is forged with the reconstruction of the narrowed outflow track using a tissue graft from the distal main pulmonary artery.[4] Lastly, an aortopulmonary shunt is created connecting the aorta to the main pulmonary artery to provide pulmonary blood flow.
The second surgery, also known as the Glenn procedure, focuses on separating the systemic and pulmonary circulation once pulmonary vascular resistance drops. This is accomplished by removing the aortopulmonary conduit followed by the creation of a bidirectional SVC-pulmonary shunt.[5]
The third surgery (Stage 3) is the Fontan procedure, in which the inferior vena cava (IVC, the large vein carrying blood back to the heart from the lower part of the body) is connected to the branch pulmonary arteries. After this surgery is completed, all the venous blood returning from the body flows directly to the lungs.[6]
^Norwood WI, Lang P, Casteneda AR, Campbell DN (October 1981). "Experience with operations for hypoplastic left heart syndrome". The Journal of Thoracic and Cardiovascular Surgery. 82 (4): 511–9. doi:10.1016/s0022-5223(19)39288-8. PMID 6168869.
^Norwood WI, Lang P, Hansen DD (January 1983). "Physiologic repair of aortic atresia-hypoplastic left heart syndrome". The New England Journal of Medicine. 308 (1): 23–6. doi:10.1056/NEJM198301063080106. PMID 6847920.
^Yabrodi, Mouhammad; Mastropietro, Christopher W. (January 2017). "Hypoplastic left heart syndrome: from comfort care to long-term survival". Pediatric Research. 81 (1–2): 142–149. doi:10.1038/pr.2016.194. ISSN 0031-3998. PMC 5313512. PMID 27701379.
^Gregory's pediatric anesthesia (5th ed.). Chichester, West Sussex: Wiley-Blackwell. 2012. p. 622. ISBN 978-1-4443-3346-6.
^Davies, Ryan R.; Chen, Jonathan M.; Mosca, Ralph S. (2011-01-01). "The Fontan Procedure: Evolution in Technique; Attendant Imperfections and Transplantation for "Failure"". Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual. 14 (1): 55–66. doi:10.1053/j.pcsu.2011.01.014. ISSN 1092-9126. PMID 21444050.
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needed] It is sometimes used as the first step in a Norwoodprocedure.[citation needed] This procedure was pioneered by the Japanese cardiothoracic surgeon...
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over the patients first few years of life. The first procedure, usually either the Norwoodprocedure or the Blalock–Thomas–Taussig shunt, is typically done...
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experimental military dental practices that are now standard procedure for the armed forces. Norwood was one of the first participants in the Army's outreach...
general procedures are utilized to address those defects: Stage I – Norwoodprocedure Stage II – Glenn procedure Stage III – Fontan procedure Prenatal...
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switch operation (ASO) or arterial switch, is an open heart surgical procedure used to correct dextro-transposition of the great arteries (d-TGA). Its...
Love is a Rainbow. 2018-04-14. Retrieved 2019-10-07.[permanent dead link] Norwood, Kristen (March 2013). "Grieving Gender: Trans-identities, Transition,...
and histology would demonstrate perifollicular fibrosis. The Hamilton–Norwood scale has been developed to grade androgenic alopecia in males by severity...
1997, but it was also denied. In January 2023, Simmons’s attorneys Joseph Norwood and John Coylefiled filed an amended application for post-conviction relief...
offender who raped, tortured and murdered at least 33 young men and boys in Norwood Park Township, near Chicago, Illinois. He became known as the Killer Clown...
United States Senate Democratic Caucus Republican Conference Politics and procedure Advice and consent Blue slip Closed session (list) Cloture Committees...
week seven, however, she improved, tying with previous frontrunner Brandy Norwood. On November 23, 2010, Grey and her partner Hough won the competition,...
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