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The Norwood procedure is a complex surgical intervention designed primarily for infants born with hypoplastic left heart syndrome (HLHS), a congenital heart defect characterized by underdevelopment of the left side of the heart. This procedure is typically the first of three surgeries used to establish a new functional pathway for blood flow, enabling the right side of the heart to pump blood to both the lungs and the rest of the body. The surgery is performed shortly after birth, usually within the first week of life. During the Norwood procedure, the surgeon reconstructs the heart by connecting the right ventricle to the aorta, the main artery that carries oxygenated blood to the body. To support blood flow during this reconstruction, a large shunt is created using a tube, often made from a synthetic material, which connects the pulmonary artery to the aorta. This shunt allows blood to flow to the lungs to receive oxygen while enabling the right ventricle to pump blood to the systemic circulation. The procedure also typically involves the removal of a portion of the atrial septum, which is a wall that separates the two upper chambers of the heart, to enhance blood flow and facilitate oxygenation. Recovery from the Norwood procedure can be challenging, as infants are closely monitored for complications such as low blood pressure, arrhythmias, or the risk of infection. Postoperative care often includes medications to enhance heart function and improve blood circulation. The Norwood procedure is part of a staged approach to managing HLHS; the subsequent surgeries, such as the Glenn procedure and the Fontan procedure, are planned for the child's first few years of life to gradually refine the heart's function and ensure adequate blood flow. While the Norwood procedure has significantly improved survival rates and quality of life for children with HLHS, it is associated with serious risks and complications. Long-term follow-up is essential, as these children may face additional health challenges, including the potential for heart failure or complications related to the unique circulatory system established through these surgeries. The Norwood procedure represents a remarkable advancement in pediatric cardiac surgery and has become a standard approach for managing one of the most complex congenital heart conditions. Successful outcomes rely not only on the surgical technique itself but also on the comprehensive, multidisciplinary care that children receive throughout their development. The journey for families navigating HLHS is often filled with emotional highs and lows, and the Norwood procedure is a critical step in creating hope for a healthier future for these children.
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