The Norwood Procedure: Twenty Years Later
Patricia Hickey, RN, MS, MBA
Peter Laussen, MD
This edition of Heart Murmurs commemorates the
20th anniversary of the publication of a landmark paper
by Drs. Norwood, Lang and Hansen describing the first
successful surgical treatment for hypolastic left heart
syndrome (HLHS) at
Children's Hospital Boston.
The article appeared in the
New England Journal of
Medicine, and heralded a
major advance in the
management of newborns
with HLHS, which was
subsequently extended to
other single ventricle malformations with associated aortic
outflow hypoplasia or atresia.
The results from this procedure have improved
substantially over the past 20 years, and we are pleased
to present two articles in this issue of Heart Murmurs that
reflect these changes. Peter Lang, MD, Senior Associate in
the Department of Cardiology, was an author on the
original paper and pioneered much of the understanding
about single ventricle physiology. Richard Jonas, MD, was
a surgical resident at the time when Dr. Norwood was
developing his surgical procedure, and in his report he
describes a further adaptation of the original procedure that
will possibly contribute to more successful outcomes.
Collaborative practice among the interdisciplinary team
has been central to excellent outcomes for these patients. In
her article, Dr. Martha Curley
discusses the science of
contemporary nursing and
highlights research studies
currently being conducted by
cardiovascular staff nurses at
Children's Hospital Boston. As
Director of Cardiovascular and
Critical Care Nursing Research,
she is building a program of nursing research in this specialty.
Also in this edition of Heart Murmurs, we are honored
to present an article by Barry Keane, MD, Senior Associate
in the Department of Cardiology, who recently retired from
clinical cardiology practice. Dr. Keane provides a historical
perspective of the development of cardiac catheterization
at Children's Hospital Boston. Dr. Keane is a much admired,
respected and beloved figure in the Cardiovascular Program
at Children's Hospital; as recently as this year he was
honored by the hospital's cardiology fellows as Teacher
of the Year.
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Physiologic Repair of Aortic Atresia
Hypoplastic Left Heart Syndrome
William I. Norwood, MD, Peter Lang, MD
and Dolly D. Hansen, MD
New England Journal of Medicine
308:23-26 (January 6), 1983
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