The Modified Norwood Procedure at Necker Hospital: Stage I and II for Hypoplastic Left Heart Syndrome

We describe a modified Stage I neonatal surgical palliation for hypoplastic left heart syndrome inspired by both the Norwood and hybrid procedures. This new technique consists in: (1) replacement of the patent ductus arteriosus and aortic arch plasty with a pulmonary homograft, (2) banding of both t...

Full description

Saved in:

Bibliographic Details
Published in:	Operative techniques in thoracic and cardiovascular surgery 2022, Vol.27 (3), p.313-326
Main Authors:	Pontailler, Margaux, Gaudin, Régis, Raisky, Olivier
Format:	Article
Language:	eng
Subjects:	Hybrid Norwood procedure Hypoplastic left heart syndrome Norwood procedure Pulmonary artery banding Pulmonary homograft
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	We describe a modified Stage I neonatal surgical palliation for hypoplastic left heart syndrome inspired by both the Norwood and hybrid procedures. This new technique consists in: (1) replacement of the patent ductus arteriosus and aortic arch plasty with a pulmonary homograft, (2) banding of both the right and left pulmonary arteries (PA), (3) atrial septectomy, and (4) reimplantation of the Aorta (when needed). This surgery is performed under cardio-pulmonary bypass without aortic cross clamping, except when the ascending Aorta is atretic and needs to be reimplanted. Stage II consists in the division of the pulmonary bifurcation, PA branch plasty (with debanding), bidirectional cavopulmonary shunt and Damus-Kaye-Stansel anastomosis. This new surgical procedure allowed us to obtain hemodynamically stable postoperative patients and decrease by twice our mortality rate after Stage I palliation in hypoplastic left heart syndrome but with frequent left PA stenosis or hypoplasia.
ISSN:	1522-2942 1532-8627