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| City | Cost (USD) | |
|---|---|---|
| Jeddah | $60,000 – $100,000 | Explore More |
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The Norwood procedure enhances blood circulation in newborns with hypoplastic left heart syndrome (HLHS). This surgery allows the right ventricle to compensate for an underdeveloped left ventricle and aorta. Post-operation, the right ventricle pumps blood to the lungs for oxygenation and also circulates oxygen-rich blood throughout the body.
This surgery allows the right side of a baby’s heart to send oxygen-rich blood to the body, a function typically performed by the left side. In a baby with HLHS, the left side of the heart is not developed enough to handle this task.
After the surgery, the right ventricle continues its normal function of pumping deoxygenated blood to the lungs. However, it also takes on the role of the left ventricle by pumping oxygenated blood to the rest of the body.
While this does not maintain the separation between oxygenated and deoxygenated blood like a normal heart, it significantly improves oxygen delivery to the baby’s cells and tissues, offering a better quality of life despite not being a perfect solution.
Who needs to have a Norwood procedure?
Babies with hypoplastic left heart syndrome (HLHS) require this surgery within the first few weeks of life. Due to their underdeveloped left ventricle, the Norwood procedure allows their right ventricle to execute the functions of both ventricles.
For the first few days after birth, a baby’s blood can flow between the aorta and pulmonary artery through the patent ductus arteriosus, allowing the right ventricle to send blood to both the lungs and the body. However, once this opening closes naturally after birth, the right ventricle can no longer send blood to the body, necessitating the Norwood procedure.
The Norwood procedure is the first of three surgeries done to correct hypoplastic left heart syndrome (HLHS). This congenital heart defect occurs in only a few babies and involves underdevelopment of the left side of the heart. It assists in redirecting blood flow so the single working right ventricle can pump blood to the lungs and the body.
This disorder is usually diagnosed before birth with a fetal echocardiogram or after birth for evidence such as blue skin colouration (cyanosis), weak feeding, quick breathing, or sleepiness. Early neonatal intervention and surgery consultation are mandatory.
Preparation is initiated in the neonatal intensive care unit (NICU) where the infant is stabilised with medications (e.g., prostaglandin to maintain patency of the ductus arteriosus). Diagnostic studies such as echocardiograms, chest X-rays, and blood work are obtained to prepare for surgery.
During the Norwood procedure, the surgeon creates a new aorta from the current pulmonary artery and attaches it to the right ventricle. A shunt (Blalock-Taussig or Sano shunt) is inserted to deliver blood to the lungs, enabling the right ventricle to assume systemic and pulmonary circulation.
The operation is involved and lasts 5 to 6 hours or more. It is done under general anesthesia with a heart-lung bypass machine. A few weeks' hospital stay in the NICU or cardiac ICU is anticipated after surgery.
The main advantage is lifesaving palliation for babies with HLHS. It helps the infant to live and develop until it can receive the subsequent phases of treatment: the Glenn and Fontan surgeries.
Recovery consists of intensive observation in the ICU, mechanical ventilation, and weaning progressively off support. Feeding support and medications to sustain cardiac function are typically needed. Ongoing growth and observation are necessary until the following procedure at 4–6 months old.
Survival has dramatically improved; early survival is approximately 75–85% at advanced centres. Long-term prognosis is based on global heart function, presence of additional anomalies, and success of the staged surgical approach.
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