[2][3] Variations of the Norwood procedure, or Stage 1 palliation, have been proposed and adopted over the last 30 years; however, its basic components have remained unchanged.

A connection between left and right atria (collecting chambers of the heart) is established via atrial septectomy, allowing blood arriving from the lungs to travel to the right ventricle.

[7] Without surgical repair, infants born with a single ventricle cardiac defect face almost certain mortality in the first year of life.

[5] While the Norwood procedure is the standard of care for single ventricle cardiac defects, there are other treatment options for patients depending on their unique anatomy.

[13][14] A stent is placed in the ductus arteriosus to keep it patent and bands are placed over both the left and right pulmonary arteries to limit pressure and over-circulation to the lungs.

[16][17] Families can also elect to pursue comfort care for their newborns, especially if there are concomitant anatomic defects or genetic syndromes with poor prognosis.

At this point in the surgery, the right ventricle is directly connected to systemic circulation through the Neoaorta or the reconstructed aortic outflow track.

[24] The Norwood procedure is a complex and high-risk surgery with high rates of morbidity and mortality despite advancements in surgical technique, perioperative care, and postoperative monitoring.

This time is very high-risk for infants because the single ventricle must pump to both the systemic and pulmonary circulations, with mortality rates ranging from 2%-20%.

[25][28] Due to the balance required to maintain adequate blood flow to the systemic and pulmonary circulations, infants in the interstage period face multiple risks: Long-term survival rates for children with single ventricle physiology are improving as medical and surgical advancements continue.

In the major SVR trial (Single Ventricle Reconstruction) the transplant-free survival rate was only 54-59% amongst patients who underwent the Norwood procedure.

There, he continued to develop and refine his work: he was responsible for Poland's first ever Fontan procedure in a patient with single ventricle pathology.