The Norwood procedure for hypoplastic left heart syndrome and related malformations is one of the most technically challenging and high-risk surgical procedures for patients with the congenital heart anomaly.
The study objective was to evaluate various types of Norwood arch reconstruction methods and to show the factors that affect the cardiac workload of the single ventricle.
The result that Creation of a large anastomotic space and a smooth aortic arch angle reduced wall shear stress and energy loss, and should improve long-term cardiac performance after the Norwood procedure.

Keiichi Itatani, Kagami Miyaji, Yi Qian, Jin Long Liu, Tomoyuki Miyakoshi, Arata Murakami, Minoru Ono, Mitsuo Umezu, "Influence of surgical arch reconstruction methods on single ventricle workload in the Norwood procedure", The Journal of Thoracic and Cardiovascular Surgery, 144 (2012) 130-138.