Stage I palliation of hypoplastic left heart syndrome.
(A) Stage I palliation (Norwood procedure) using a modified Blalock-Thomas-Taussig shunt (mBTS; also commonly called a Blalock-Taussig shunt) for provision of pulmonary blood flow. The shunt originates from the innominate artery and inserts into the central pulmonary artery.
(B) Stage I palliation using an RV-to-PA conduit (Sano modification) for provision of pulmonary blood flow. A larger 5 or 6 mm graft is placed between the RV and the central PA.
(C) Stage I palliation using a hybrid approach. Pulmonary blood flow is restricted with branch PA bands, and the ductal patency is maintained by placement of a stent. A stent is placed to create a nonrestrictive atrial septal defect.
Reproduced with permission from: Tweddell J, Hoffman G, Ghanayem N, et al. Hypoplastic left heart syndrome. In: Moss and Adams' Heart Disease in Infants, Children and Adolescents: Including the Fetus and Young Adult, 7
th ed, Allen H, Driscoll D, Shaddy R, et al. (Eds), Lippincott Williams & Wilkins, Philadelphia 2008. Copyright © 2008 Lippincott Williams & Wilkins.
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