title: [Results of Norwood type operation for interrupted aortic arch complex; surgical decision making].
abstract: BACKGROUND
  Interrupted aortic arch (IAA) is associated with a multitude of lesions ranging from isolated ventricular septal defect to hypoplastic left ventricle or severe subaortic stenosis (SAS). Left ventricular outflow obstruction such as SAS continues to be an important factor for deciding the surgical procedure between univentricular and biventricular repairs.
  
  
  METHODS
  A retrospective study was conducted in 8 consecutive infants aged 14 to 117 days and operated on between 2004 and 2009. Seven patients had undergone bilateral pulmonary artery banding for pulmonary high flow regulation. All patients underwent Norwood-type operation (4 with systemic to pulmonary artery shunt, 3 with right ventricle to pulmonary artery shunt, and 1 with bidirectional Glenn shunt).
  
  
  RESULTS
  One patient died 2 months after surgery due to respiratory failure. The others were discharged in a good condition. One patient underwent Rastelli-type operation and biventricular circulation was achieved. The other 6 patients were all Fontan candidates.
  
  
  CONCLUSIONS
  Satisfactory initial palliation can be achieved by Norwood-type operation for IAA with severe SAS or hypoplastic left ventricular-aortic complex.
authors.affiliation: Division of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Maekawa
authors.forename: Takahiko
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Umezu
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ohashi
authors.forename: Yorikazu
authors.initials: Y
authors.lastname: Harada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasukochi
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Takigiku
authors.forename: Kota
authors.initials: K
authors.lastname: Takei
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakano
authors.forename: Nao
authors.initials: N
authors.lastname: Inoue
authors.forename: Tesshu
authors.initials: T
authors.lastname: Otagiri
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hashida
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000150:complications; D003657:Decision Making; D005260:Female; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000150:complications; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D058327:Norwood Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome