Norwood-type operation with adjustable systemic–pulmonary shunt using hemostatic clip

The postoperative course of a patient with hypoplastic left heart syndrome after a first-stage Norwood operation is governed to a large extent by the balance between the systemic and pulmonary circulations. Here we describe a simple and convenient technique for establishing an optimally sized systemic–pulmonary shunt by the application of a hemostatic clip. The method has been used in 6 patients.