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 The Norwood procedure is the first in a series of three open-heart surgeries that gradually improve specific life-threatening forms of congenital disease heart in which one or both of the lower chambers of the heart (ventricles) are defective. The three surgeries are done at three different ages, which are as follows:
- Stage I (the Norwood operation) is done soon after birth. This is known as a palliative operation. In other words, the Norwood procedure is not meant to correct any underlying abnormalities, but to ease symptoms and allow normal development long enough that the baby can be ready for additional surgeries.
- Stage II (the bidirectional Glenn procedure, partial Fontan, semi-Fontan or a staging procedure before the Fontan) is done at three to nine months of age.
- Stage III (the Fontan procedure) is done between 18 months and 4 years of age.
The term "Norwood procedure" is sometimes used to refer to all three stages of the surgeries together.
Some of the life-threatening heart defects that may be treated by the Norwood procedure include:
- Hypoplastic left heart syndrome (HLHS). Severe defects leave the left side of the heart (i.e., the left ventricle and related valves and vessels) severely malformed and unproductive. The left ventricle is unable to perform its natural function of pumping oxygen-rich blood out to the rest of the body. This is the condition most often treated by the Norwood procedure. The aorta, the main artery out to the body, is also abnormally underdeveloped with this condition.
- Some variants of tricuspid atresia. The tricuspid valve located between the right atrium and the right ventricle is either closed or missing altogether, thus obstructing blood flow from the right atrium into the right ventricle.
- Various other faulty connections among the upper and lowers chambers of the heart, resulting in the heart’s inability to maintain good blood circulation.
- Any condition in which the patient has only one functioning ventricle.
 The Norwood procedure helps to re-route blood flow to and from the lungs, keeping the heart functioning and oxygen-rich blood flowing to the body until all three surgeries are complete. It may also require reconstructing the aorta.
The complete three-stage procedure can almost always be performed, and it offers great hope to the vast majority of infants who would probably not survive a month without it.
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