Norwood Procedure: Symptoms, Classification, Diagnosis & Recovery

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.

Babies with hypoplastic left heart syndrome (HLHS) have various signs and symptoms related to their undeveloped left ventricle, including:

• Cyanosis (A bluish tint to the skin, lips, and nails caused by inadequate oxygenation of the blood.)
• Rapid Breathing (Breathing quickly to compensate for low oxygen levels in the blood.)
• Difficulty feeding or poor weight gain due to fatigue and low energy levels.
• Excessive sleepiness or lack of energy.
• Hands and feet may feel cold due to poor circulation.
• A faint pulse, particularly in the extremities.
• An abnormal heart sound is heard through a stethoscope.