4.5-mm "Ready-Made" Conduit for Primary Chest Closure After Norwood Procedure.

The Norwood procedure with the right ventricle-to-pulmonary artery (RV-PA) conduit has been the standard procedure for hypoplastic left heart syndrome. However, postoperative management can be challenging related to finding the correct balance between pulmonary and systemic blood flow. One can use hemostatic clips on the RV-PA conduit to temporarily restrict pulmonary blood flow. However, the hemodynamics would become unstable after clip removal. Here we describe a novel technique that allows precise pulmonary blood flow without the addition and removal of clips on the RV-PA conduit, allowing primary chest closure after the Norwood procedure.