NORWOOD PROCEDURE

Course overview

THE NORWOOD PROCEDURE IS A COMPLEX SURGICAL INTERVENTION PERFORMED IN NEONATES BORN WITH HYPOPLASTIC LEFT HEART SYNDROME OR OTHER FORMS OF SINGLE VENTRICLE HEART DISEASE. THE GOAL OF THE NORWOOD PROCEDURE IS TO ANATOMICALLY RESTRUCTURE THE HEART TO ENABLE THE LONE FUNCTIONAL VENTRICLE TO PUMP BLOOD TO BOTH THE SYSTEMIC AND PULMONARY CIRCULATIONS. THE AORTA AND PULMONARY ARTERY ARE RECONSTRUCTED DURING A NORWOOD PROCEDURE, AND A SHUNT IS PLACED TO PROVIDE PULMONARY BLOOD FLOW. DESPITE ITS COMPLEXITY, THE NORWOOD PROCEDURE IS THE INITIAL PROCEDURE IN A SERIES OF STAGED PALLIATIVE SURGERIES TO IMPROVE SYSTEMIC AND PULMONARY CIRCULATION AND ENHANCE OVERALL SURVIVAL FOR PATIENTS WITH SINGLE VENTRICLE PHYSIOLOGY. UNFORTUNATELY, DESPITE DECADES OF TECHNICAL AND PROCEDURAL ADVANCES, THE OVERALL NEONATAL MORTALITY RATE FOLLOWING A NORWOOD PROCEDURE APPROXIMATES 15%.THIS ACTIVITY FOR HEALTHCARE PROFESSIONALS REVIEWS THE UNIQUE ANATOMICAL AND PHYSIOLOGICAL CONSIDERATIONS OF PATIENTS WITH SINGLE VENTRICLE CARDIAC DEFECTS, INDICATIONS FOR THE NORWOOD PROCEDURE, GUIDANCE REGARDING INTRAOPERATIVE SHUNT SELECTION, PROCEDURAL STEPS, COMPLICATIONS, AND LONG-TERM FOLLOW-UP DATA FOR THIS CARDIAC PROCEDURE. THE ACTIVITY ALSO HIGHLIGHTS AND UNDERSCORES THE CRITICAL ROLE OF THE INTERPROFESSIONAL TEAM IN CARING FOR AND IMPROVING OUTCOMES FOR PATIENTS UNDERGOING A NORWOOD PROCEDURE.