Innovations on the Norwood Procedure: Sustained Total All-Region (STAR) Perfusion

Recovery following the neonatal Norwood procedure is often complicated by bleeding, acute kidney injury, systemic inflammatory response, and low cardiac function [1]. The traditional conduct of this operation under deep hypothermic circulatory arrest likely exacerbates these problems. Total body perfusion during Norwood reconstruction may improve post-operative recovery by cooling to only mild hypothermia and eliminating ischemic time in all vascular beds. Here, we present a novel technique for sustained total all-region (STAR) perfusion of the heart, upper body, and lower body throughout the Norwood operation [2, 3].

References

[1] Hornik CP, He X, Jacobs JP, et al. Complications after the Norwood operation: an analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg. 2011;92(5):1734-40.
[2] Turek JW, Hanfland RA, Davenport TL, et al. Norwood reconstruction using continuous coronary perfusion: a safe and translatable technique. Ann Thorac Surg. 2013;96(1):219-23.
[3] Andersen ND, Prabhu NK, Turek JW. Sustained Total All-Region (STAR) Perfusion for Norwood Reconstruction. Operative Techniques in Thoracic and Cardiovascular Surgery 2020;25(3):126-39.