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Norwood procedure is a type of a heart surgery conducted to treat patients with hypoplastic left heart syndrome, mitral atresia, and other types of congenital heart defects that result in a single ventricle for blood circulation. This surgery, performed for the first time in 1981, is conducted in three steps.

Norwood procedure is conducted in patients whose heart is not able to pump blood to the different parts of the body. As a part of Norwood surgery, the doctors connect the single ventricle in the heart to the systemic circulation. To be able to do this, the surgeons first stop the circulation of the impure blood to the lungs from the ventricles and create an alternative pathway for it. During the Norwood surgery, the right side of the heart is resurrected as the main pumping chamber. Sometimes, it is the right ventricle that supplies blood to both the lungs and the rest of the body parts.

Norwood surgery is mostly conducted during the first week of life. It is usually conducted as a part of a series of heart surgeries required to correct the heart defect. It involves the reconstruction of the aorta using the pulmonary artery. During the same surgery, a Blalock-Taussig (BT) shunt is placed to maintain the flow of blood from the heart to the lungs.

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Before the Treatment

There is not much you can do as a parent before the Norwood procedure. This is because it is conducted during the initial few days of life as soon as your baby is born with single ventricular circulation. The doctor may check the baby for its health and conducted a few tests before performing the procedure.

How it is Performed

The following three steps are performed during the surgery:

Step 1: Creation of a new aorta

The surgeons first split the pulmonary artery into two parts. The end closest to the lungs is sewn and the far end is sewn into the aorta. A patch is put on this conjunction is make the new aorta stronger and bigger. This way, the blood leaving the heart through the pulmonary valve in the right side to the rest of the body travels through the newly created aorta.

Step 2: Placement of a BT shunt

A BT shunt is a hollow tube that connects the pulmonary artery to the new aorta. It helps pump some blood that eventually reaches the lungs.

Step 3: Removal of walls between the atria

In the last step, the wall between the upper two chambers of the heart, the atria, is removed. This allows the flow of blood coming back from the lungs to the right upper chamber. The blood eventually reached the right lower chamber (ventricle) and is pumped to the rest of the body.


After the surgery, once the blood circulation resumes, the right side of the heart of the baby pumps a mixture of blue and red blood. Blue blood is the deoxygenated blood that comes from the different parts and red blood is the oxygenated blood coming from the lungs. This gives a blue or a dusky appearance to the skin and the lips of the baby.

Because the blood of the baby is mixed, the oxygen level in the blood circulating in the body is less than normal. However, the body of the baby adjusts to this levels and is not affected by it. A majority of babies who undergo Norwood surgery are released from the hospital after 10 days of the surgery. Doctor prescribe three to four medications that must be given to the baby in the days to come.  Breastfeeding is highly recommended for babies who have had a heart surgery. Some babies may be given breast milk through a feeding tube for a few days before normal feeding is resumed. For increased calories intake, breast milk can be supplemented with extra powders and other add-ons.

Parents of the baby must learn how to care for the baby at home and feed them. They must learn all the necessary skills from the nurse and take guidance from the surgeon. Babies who have had a Norwood operation grow normally like any other baby. They smile and roll over and the rest of the developmental stages are the same. Some babies may, however, face trouble gaining weight and they must be given richer milk to drink for normal development.

Cost Comparison

Cost of Norwood Procedure

Norwood heart surgery is a critical procedure that must be performed by a highly experienced and skilled cardiac surgeon. This is the reason why the cost of Norwood procedure also depends on the surgical skills and feed of the surgeon performing the surgery.

Nonetheless, the cost of Norwood surgery in India is much less than any other country in the world. This surgery is performed at almost all multispecialty and cardiac care hospitals. The Norwood procedure cost in India is less than not only the Western countries but also a majority of its medical tourism counterparts. The total Norwood surgery cost in India, however, depends on the length of hospital stay, hospital charges, ICU charges, and several other factors. The following table highlights the cost of Norwood operation in India and some of the other popular medical tourism destinations:

Treatment cost in India: 12500
Treatment cost in Israel: n/a
Treatment cost in Spain: n/a
Treatment cost in Thailand: n/a
Treatment cost in Turkey: n/a
Treatment cost in Singapore: n/a
Treatment cost in Czechia: 11000
Treatment cost in Lithuania: n/a
Treatment cost in Tunisia: n/a
Treatment cost in United Arab Emirates: n/a
Treatment cost in Malaysia: n/a
Treatment cost in Morocco: n/a
Treatment cost in Poland: n/a

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Q: What is the Norwood heart surgery survival rate?

A: The chances of survival after Norwood procedure are almost 80 percent.

Q: Is Norwood procedure necessary?

A: This procedure is absolutely necessary for babies with single ventricular circulation for survival.

Q: Is Norwood heart surgery a minimally invasive procedure?

A: No, it is an open heart surgery.

Q: How does heart pumps during the surgery?

A: During the surgery, the body of the baby is connected to a heart-lung bypass machine for normal circulation.

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Norwood Procedure