Newborn with Norwood Physiology or Shunt-dependent Pulmonary Blood Flow Clinical Pathway — Outpatient Specialty Care and Primary Care

Determine Timing and Submit Scheduling Request

Decision guidance considerations include:

Standard recommended time is 4.5m.
Consider earlier stage II (4 months) for restrictive shunt in growing patients with otherwise straightforward anatomy
Consider later stage II (5 months) for bilateral SVC particularly if patient is on smaller side.
Note that interstage risk is higher in patients with BT shunt than RVPA conduit (Sano modification).
For patients with interrupted IVC typical time for second stage (Kawashima) is around 6 months

Discuss with surgeon if there are concerns.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.