November 26, 2010
School of Medicine, Kochi
 

Kerala’s first successful Norwood Procedure-Stage I was performed by the pediatric cardiac team at Amrita’s School of Medicine. The procedure was performed on a five-day-old baby who was diagnosed with a complex birth defect, the Hypoplastic Left Heart Syndrome (HLHS).
 

The entire left side of the baby’s heart, including the left ventricle, the main pumping chamber and the aorta, the body’s main blood vessel, was severely obstructed and underdeveloped.
 

In those with HLHSA, the right ventricle is the only pumping chamber. The blood is pumped to both lungs and the body through an embryonic channel that closes a few days after birth. When this happens, there is no way for the blood to circulate.
 

“If not corrected surgically, HLHS is uniformly fatal,” stated Dr. Sunil G. S., who led the corrective surgery.”
 

Dr. Sunil was assisted by Dr. Balu Vaidyanathan, Dr. Edwin Francis, Dr. K. Mahesh, Dr. S. G. Nair and Dr. Rakhi B.
 

Dr. Sunil elaborated on the surgery that was performed by the team.
 

“The procedure was done through standard median sternotomy employing hypothermic cardiopulmonary bypass. The main lung artery was divided and separated from its right and left branches. The divided main lung artery was used to enlarge the small aorta along with the heart’s own covering called pericardium.”
 

The reconstructed aorta will provide a single outflow from the heart. Blood will flow to the lungs through a shunt between the subclavian artery and right-sided lung artery. This Norwood Procedure-Stage I will be followed by two additional corrective surgeries when the baby grows older.
 

Together, the procedures will help with regulating the flow of excessive blood to lungs and providing a supply of blood supply to the entire body.
 

Norwood Procedure-Stage I for HLHS has been performed only in a few places in developing countries. In India, only one instance of a successful Norwood operation has been reported.
 

The extreme complexity of the heart defect and the fact that surgery is performed for a newborn baby, makes the entire procedure very challenging.
 

“Our success was due to our cohesive team work that was supported by an efficient hospital management,” stated Dr. Balu Vaidyanathan.
 

“This success has certainly raised the bar as far as the competency of the pediatric cardiac team at Amrita is concerned,” he proudly added.
 

Congratulations to the Pediatric Cardiac Team for this achievement.