Improved Pulmonary Artery Geometry After a Norwood Procedure by Using a Venaflo II Graft as an RV-MPA Conduit

Sano's modification of the right ventricle to main pulmonary artery shunt improves the surgical results of the Norwood procedure for hypoplastic left heart syndrome. Usually the transected distal stump of the main pulmonary artery is reconstructed by direct suturing of a polytetrafluoroethylene tube or suturing on a pericardial bifurcation patch. However, the resulting pulmonary artery geometry significantly affects the outcome of the staged procedure. Herein, we report our surgical strategy to improve the pulmonary artery geometry by using a commercially available Venaflo II graft (Bard, Tempe, AZ) as the right ventricle to main pulmonary artery conduit, to avoid the potential for pulmonary artery stenosis after the Norwood procedure.