Objective: To illustrate the surgical management of Norwood aneurysm, including technical tips and tricks for successful surgical correction.

Case Summary: An 18 year old male presented to us with a 8 cm Norwood aneurysm. He was born with double outlet right ventricle, d- transposition of the great arteries, mitral atresia and hypoplastic left ventricle. He was palliated successfully with a Norwood operation and modified BT shunt (2000), bidirectional Glen operation (2000) and a fenestrated latral tunnel fontan operation (2001). The video demonstrates the pre-operative work up and the procedure to successfully repair such a aneurysm. Of importance, the video demonstrates the technique of arresting the heart with cross-clamping only the original aortic component of the Norwood reconstruction.

Conclusion: With the increasing number of adult congenital cardiac patients, complex reconstructions will have to be performed in patients with palliated neonatal and infant operations. This can be performed successfully with complete understanding of the complex anatomy.