Newborn with Norwood Physiology or Shunt Dependent Pulmonary Blood Flow Clinical Pathway — Inpatient

Post-operative Echo

Procedure	Frequency	Order
Hybrid	Weekly	Select Stage I Hybrid Protocol when ordering study. Indicate other specific concerns (i.e., obstructed pulmonary vein(s), restrictive atrial septum) in the request.
Norwood	Bi-weekly	In addition to choosing the Norwood protocol when ordering an echo, indicate other specific concerns (i.e., obstructed pulmonary vein(s), restrictive atrial septum) in the request. Select Norwood Comprehensive Echo Protocol for the following: The first complete post-op study Pre-Glenn (2nd stage) assessment Any interstage readmission For all other studies, select Norwood-focused Study.

Routine Echo Surveillance – Inpatient

Hybrid Procedure	Perform weekly Select Stage 1 Hybrid Protocol when requesting study ECHO Protocol - Stage I Hybrid Protocol
Norwood Procedure	Perform biweekly Select Norwood Focused Protocol for routine q2 week follow-up imaging while inpatient ECHO Reporting – Norwood Focused ECHO Protocol
BT Shunt Placement Only	Perform 1x per month

If you have questions about any of the clinical pathways or about the process of creating a clinical pathway, please contact us.

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.