Sustained Total All-Region (STAR) Perfusion for Norwood Reconstruction With Complex Intracardiac Repair

The acute phase of recovery following the Norwood procedure can be complicated by considerable instability due in part to bleeding, acute kidney injury, systemic inflammatory response, and low cardiac function. The traditional conduct of cardiopulmonary bypass with cooling, re-warming, myocardial ischemia, and upper or lower body ischemia likely exacerbates these problems. Total body perfusion during Norwood reconstruction, without significant cooling or ischemic time to any organs, may improve postoperative recovery by reducing coagulopathy and end-organ injury. Here, we introduce a novel technique for sustained total all-region perfusion of the heart, upper body, and lower body throughout the Norwood operation.