Normally, a heart has four chambers — two upper (atria) and two lower (ventricle). The left ventricle pumps blood to the body and the right ventricle pumps blood to the lungs. When a baby is born with just one ventricle, it’s called a single ventricle heart defect. These are serious heart defects that require the highest level of skill and expertise to fix. This treatment for single ventricle heart defects is three surgeries that typically take place over your child’s first three years of life.

• Norwood procedure
• Glenn procedure
• Fontan procedure

The Norwood Procedure

This is the first of three heart surgeries to correct single ventricle heart defects. The Norwood procedure usually happens within a week of birth.

The goals of the Norwood are to make sure blood is reaching the lungs and to better control the blood flow to prevent damage to the lungs and heart.

During the Norwood, surgeons rebuild the heart so that the good ventricle can pump blood to both the lungs and to the body.

They will also begin rerouting the baby's blood flow to the lungs. This is done through several first steps, including:

• Placing a small connecting tube (shunt) between the aorta and pulmonary artery
• Removing the wall that divides the heart's top chambers
• Disconnecting the two "branch" pulmonary arteries from the main pulmonary artery
• Connecting the main pulmonary artery to the underdeveloped aorta to create a "new" aorta
• Enlarging the underdeveloped aortic arch 

The Glenn Procedure

This is the second of three heart surgeries to correct single ventricle heart defects. The Glenn operation usually happens when your child is about 6 months old.

During the Glenn, surgeons finish rerouting your baby's blood flow from the upper body to the lungs. They do this by disconnecting the large vein that carries the oxygen-poor blood from the upper body to the heart (superior vena cava). They then attach it to the artery that carries blood from the right ventricle to the lungs (pulmonary artery). As a result, the blood will go directly to the lungs without circulating through the heart at all. This new path means that the temporary shunt placed during the Norwood procedure is no longer needed. After the Glenn procedure, your baby's heart will no longer have to work twice as hard, and the risk for problems is usually lowered. 

The Fontan Procedure

This is the third and last of three heart surgeries to correct single ventricle heart defects. The Fontan procedure usually happens between 18 months and 3 years of age.

During a Fontan procedure, surgeons change the blood flow from the lower body to the lungs. They do this by connecting the vein that carries oxygen-poor blood from the lower and middle body to the heart (inferior vena cava). They attach it to the artery that carries blood from the right ventricle to the lungs (pulmonary artery). Blood flow from the lower body now joins the connection made in the Glenn procedure. Once the blood gets oxygen in the lungs, the heart's single, right ventricle pumps it out to the body.

Interstage home monitoring program: For children undergoing single ventricle surgical treatment, the time between the Norwood and Glenn procedures, commonly known as the “interstage period,” is a critical stage in their care. Our Interstage Home Monitoring Team gives families a comprehensive home monitoring plan, tracking tools and direct access to interstage team members to ensure proper support.

Fontan Survivorship Program: Although life expectancy and outcomes after the Fontan procedure have improved, some patients may develop health problems later in life. Our Fontan Survivorship Program is staffed by a team of experts trained to provide the best possible care for children and adults who have had the Fontan procedure.

Outstanding outcomes: If your child needs surgery, you’ll have access to nationally recognized heart surgeons. The Herma Heart Institute has some of the best results for even the most complex types of heart disease. 

Commitment to innovation: Our team is leading the way in congenital heart disease research. We are working to discover breakthrough treatments and procedures to improve outcomes.

Support beyond the clinic: We know that our heart families need support that extends beyond the clinic. That’s why we invest in programs that help children thrive and get them back to being kids sooner:

• Neurodevelopmental Follow-up Program
• Educational Achievement Partnership Program