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J Thorac Cardiovasc Surg 2007;134:1065-1066
© 2007 The American Association for Thoracic Surgery

Brief Communication

Norwood modification in a patient with hypoplastic left heart and a right aortic arch

Priti M. Patel, MDa, Heather L. Bartlett, MD, FACCa, Thomas Scholz, MD, FACCa, Jeffrey Burzynski, MD, FACPb, Douglas M. Behrendt, MDc, Harold M. Burkhart, MDc,*

a Department of Pediatric Cardiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
b Department of Pediatric Critical Care, University of Iowa Hospitals and Clinics, Iowa City, Iowa
c Department of Pediatric Cardiac Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Received for publication April 12, 2007; accepted for publication April 23, 2007.

* Address for reprints: Harold M. Burkhart, MD, Division of Cardiac Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905. (Email: Burkhart.harold@mayo.edu).

The first 20% of the full text of this article appears below.

We report a modification of the Norwood procedure in a neonate with a right aortic arch, an aberrant left subclavian artery, and a left ductus arteriosus in a variant of hypoplastic left heart syndrome.

Clinical Summary

A male infant (3.4 kg) was born with unbalanced atrioventricular septal defect with a hypoplastic left-sided atrioventricular valve, left ventricle, and aortic valve situs solitus, total anomalous pulmonary venous connection to the right atrium, right aortic arch, aberrant left subclavian artery, left ductus arteriosus, and left descending aorta. The ascending aorta of the right aortic arch was 2 to 3 mm in diameter, and no left aortic arch was present. He underwent a Norwood procedure with a Sano shunt 2 days after birth.

In the operating room, a 3.5-mm polytetrafluoroethylene shunt (Gore-Tex shunt; W. L. Gore & associates, Inc, Flagstaff, Ariz) was sutured to the larger left carotid artery and cannulated. The right atrium was cannulated and the patient was cooled to 18°C. The right aortic arch crossed posterior to the trachea. The . . . [Full Text of this Article]






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