"I love you and want for you all things that make you happiest; and I guess you, not I, are the one who knows best what those things are."

Tuesday, September 24, 2013

The Norwood

What is the Norwood Procedure?
On his 6th day of life, Charlie underwent his first open heart surgery. The procedure performed was a modified Norwood with a Blalock-Taussig shunt. It is the first of three staged surgeries designed to help Charlie's heart function.

The most urgent problem with Charlie's birth heart was that the heart was unable to adequately pump blood to the to the body (systemic circulation). The goal of the Norwood procedure is to connect the single ventricle to the systemic circulation. To accomplish this, blood flow to the lungs is disrupted, and therefore an alternative path must be created to supply the lungs.

The heart is accessed through the sternum and Charlie was placed on complete heart and lung bypass throughout the duration of the procedure. The surgery can be broken down into two main components.

Providing Increased Circulation to the Body
In order to convert Charlie's left ventricle into the main pumping chamber the lower portion of the pulmonary artery was separated from the left and right portions of the pulmonary artery and joined with the aorta. This allows the blood, a mixture of oxygenated and deoxygenated, to be pumped to the body via the left ventricle through Charlie's pulmonary valve. The aorta was widened using a Gor-Tex graft to allow for greater blood flow out to the body.

Providing Alternative Circulation to the Lungs
Since the remainder of the pulmonary artery was disconnected from the heart a modified Blalock-Taussig Shunt (a kind of plastic tubing much like a straw) was used to connect the subclavian artery to the pulmonary artery. In Charlie's case, blood comes from the left ventricle, through the pulmonary valve, the reconstructed aorta, the subclavian artery, and the shunt, to the lungs.

Charlie - Norwood

The first successful Norwood procedure was performed in 1981. In the world of medicine it's still considered a fairly new procedure. While no one can tell us if Charlie will live to be 60, 70, or 80 having had this operation - they can tell us that some kids have graduated college and started successful careers.... And given the alternative, we'll take that!

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