The Norwood operation as first-stage palliation for hypoplastic left heart syndrome has been standardized in most centers. However, in the presence of anomalies of aortic arch anatomy or position, or other anatomical variants, important modifications of the procedure may become necessary. This report summarizes surgical techniques to address these challenges.
Keywords: CHD; Norwood procedure; aortic arch; hypoplastic left heart syndrome; univentricular heart.