Korean J Thorac Cardiovasc Surg.  2001 Jul;34(7):547-551.

Modified Norwood Procedure without Circulatory Arrest and Myocardial Ischemia: Report of 2 cases

• Baek MJ
• Kim WH
• Jeon YB
• Kim SC
• Kong JH
• Ryu JW
• Oh SS
• Nah CY
• Kim YM
• Lee JY
• Lee SK
• Kim WS
• Lee CH
• Lee YT
• Yoon YW
• Park YK
• Kim CW

Abstract

The effects of deep hypothermia and circulatory arrest during aortic arch reconstruction are associated with potential neurologic and myocardial injury. We describe a surgical technique that two patients underwent a modified Norwood procedure without circulatory arrest and myocardial ischemia. One was 13-day-old female patient, weighing 3.1kg, having a variant of hypoplastic left heart syndrome and another was 38-day-old male patient, weighing 3.4 kg, diagnosed Taussig-Bing anomaly with severe aortic arch hypoplasia, coarctation of the aorta, and subaortic stenosis. The arterial cannula was inserted in innominate artery directly. During Norwood reconstruction, regional high-flow perfusion into the inominate artery and coronary perfusion were maintained and there were no neurologic, cardiac, and renal complications in two patients. This technique may help protect the brain and myocardium from ischemic injury in patients with hypoplastic left heart syndrome or other arch anomalies including coarctation or interruption.

Keyword

Heart arrest, indnced; Total circulatory arrest, indnced; Norwood procedure; Surgery method; Catheterization, peripheral

MeSH Terms

Aorta, Thoracic
Aortic Coarctation
Arteries
Brachiocephalic Trunk
Brain
Catheterization, Peripheral
Catheters
Constriction, Pathologic
Double Outlet Right Ventricle
Female
Humans
Hypoplastic Left Heart Syndrome
Hypothermia
Male
Myocardial Ischemia*
Myocardium
Norwood Procedures*
Perfusion