Norwood procedure

The Norwood 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.

About 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.

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.

Worldwide leaders in Norwood survival

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 Hospital of Wisconsin has one of the best published survival rates in the world for the Norwood procedure. This is one of the factors behind our "3-star" rating by the Society of Thoracic Surgeons for the quality of our congenital heart surgery outcomes (the highest rating possible). See our overall pediatric congenital surgery outcomes.