Technical Aspects and Common Pitfalls of Norwood With Modified Blalock Taussig Shunt

Abstract

The Stage 1 Norwood procedure is the first of 3 stages in the surgical palliation of hypoplastic left heart syndrome and certain other single ventricle lesions with systemic outflow obstruction. In this article, we address some technical aspects and common pitfalls of the Norwood procedure with systemic to pulmonary shunt for HLHS palliation. We report our results with the Norwood with Blalock Taussig shunt in a cohort of 44 patients over a 7-year period in 2 institutions in Argentina. The results of the Norwood procedure have improved significantly through the understanding and refinement of the surgical techniques. Procedures must be technically perfect since residual lesions are poorly tolerated. Norwood with a modified Blalock Taussig shunt can be performed with low mortality and may provide excellent long-term outcomes.

Narrative review of single ventricle: where are we after 40 years?

“…In hypoplastic left heart syndrome, the surgical neonatal approach is the Norwood procedure, either with a modified Blalock-Taussig shunt ( 78 ) or with a Sano right ventricle to pulmonary artery conduit ( 79 ) with recent improvement in results ( 80 , 81 ). The Sano conduit has utilized either a ring reinforced tubular prosthesis ( 82 ), stent-less pulmonary valved conduit ( 83 ), or valved femoral venous homograft ( 84 ).…”