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Temporary Single Ventricle Palliation for Severe Diastolic Dysfunction in a Biventricular Heart

We describe a neonate with severe left ventricular (LV) dysfunction manifesting soon after birth, who required extracorporeal life support (ECLS). Multiple attempts at separation from ECLS resulted in high left atrial pressures and hemorrhagic pulmonary edema. The inability to separate from ECLS after ten days prompted an unconventional treatment strategy. We performed a modified Norwood operation for LV rehabilitation on day 10 of ECLS. This was followed by successful separation from ECLS. Left ventricular function recovered, and the child underwent conversion to a biventricular circulation on 128 days post-Norwood.