Norwood procedure

About the Norwood procedure | Monitoring at home | Outcomes

The Norwood heart procedure is the first of three staged congenital heart surgeries to correct hypoplastic left heart syndrome (HLHS) and other single ventricle heart defects. The Norwood operation usually occurs within a week of birth.

Worldwide leaders in Norwood procedure survival

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The Norwood operation is the most complicated of the three single-ventricle treatment surgeries to correct single ventricle heart defects and the most risky. Currently, most major pediatric heart centers offer a survival rate of 75 percent or more. Thanks to innovations such as specialized monitoring in the operating room and approaches to care after surgery in the cardiac intensive care unit (CICU), Children's Wisconsin has one of the best published survival rates in the world for the Norwood procedure.  Learn more about our heart surgery outcomes.

Note: Data is provided from the Society of Thoracic Surgeons (STS). New data is not available beyond June 2019, as STS is in the process of refining their reporting methodologies. Hospitals are also limited in providing updated data due to the demands of the COVID-19 pandemic.

Specialized post-Norwood monitoring at home

For babies with single ventricle disease, the time after a Norwood procedure and before the second, Glenn, procedure is called the "interstage period" – a stage which requires very cautious care. Our researchers at Children's have developed a proven Interstage Home Monitoring Program that can prevent complications, encourage your baby's growth and improve success for survival and quality of life. Your baby's caregivers will help you completely prepare for caring for your baby at home and stay in close touch with you to make sure your baby continues to thrive.

What is the Norwood procedure?

The goals of the Norwood operation 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 procedure, surgeons begin to rebuild the heart so that the right ventricle can take over both jobs of pumping blood to the lungs and to the body. They will also begin rerouting the baby's blood flow to the lungs through several first surgical steps, including:

• Placing a small shunt, or connecting tube, between the aorta and pulmonary artery
• Removing the muscle 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

Since the Norwood procedure requires open heart surgery, the heart-lung machine will be used to temporarily take over for your baby's breathing and circulation during the five- or six-hour procedure. Babies usually stay in the hospital for two to three weeks after surgery, starting in the cardiac intensive care unit (CICU) and then moving to another hospital unit. Learn more about postoperative care following surgeries for hypoplastic left heart syndrome.