How I Do the Norwood Operation

The Norwood procedure can be performed with several variations including a sustained total all-region (STAR) perfusion technique, introduced at our institution 5 years ago and well described in a prior Operative Techniques article. Regardless of technique heterogeneity, national outcomes continue to demonstrate that the Norwood procedure carries one of the highest mortalities of all congenital heart operations. Our technique of STAR perfusion provides total body perfusion during the entire Norwood reconstruction, avoiding coagulopathy associated with significant cooling and ischemic time to end-organs. Over the past few years, we have refined the technique, and describe key variations and modifications in this article.