No abstract

There is wide variability of hemodynamics and oxygen transport after the Norwood procedure. The decrease in VO2 during the first 24 hours is the main contributor to improving the balance of oxygen transport. DO2 is most closely correlated to SVR and hemoglobin and weakly correlated to PaO2. It is not correlated to Qp. Postoperative management strategies to decrease VO2 and maintain a high hemoglobin level and a low SVR appear to be rational.

Survival of neonates with complex congenital heart disease is influenced more by patient and management factors than by institution or surgeon experience. Institutional excellence in managing some diagnostic groups does not indicate similar performance for all diagnostic groups. Weighted risk-adjusted comparisons could provide a mechanism to improve results in institutions with less than optimal outcomes.