Technical modification of the neoaortic reconstruction in Norwood procedure: sparing of anterior wall of the main pulmonary artery.

The growth potential of the neoaorta after the stage I Norwood procedure could be limited when the patient has a small ascending aorta. Patients with hypoplastic left heart syndrome usually have a large main pulmonary artery (MPA) and from its posterior wall both pulmonary arteries arise. We describe a modified technique that spares a large anterior wall of the MPA in the neoaortic reconstruction of Norwood procedure to enhance the growth potential of the neoaorta.