追悼～小児・先天性心臓外科医William (Bill) Norwood先生～
日本中の、世界中の外科医が目標にしていた小児・先天性心臓外科領域の巨人 William (Bill) Norwood先生が先の12月13日に旅立たれました。
Sent on Behalf of Young Hearts Council Leadership
Dear Members of the Young Hearts Council,
As many of you are already aware, Dr. William (Bill) Norwood passed away on December13, 2020 at the age of 79 years. Dr. Norwood was a true “Giant” in the field of congenital heart disease.
His innovative approach,perseverance, and desire to improve the lives of children with severe forms ofcongenital heart disease have had a lasting impact on our field. Below is a testimonial authored by Dr. Marshall Jacobs that very nicely summarizes some of Dr. Norwood’s most important contributions.
Shelley Miyamoto, MD, FAHA
Chair, Young Hearts Council
William Imon Norwood, Jr. was born in Camden, Arkansas April 21, 1941.
Bill’s family moved to Los Alamos, New Mexico, where his father, a scientist, worked at the newly created Los Alamos Laboratory. Bill won an appointment to attend the Air Force Academy following High School graduation. He left the Academy after two years, transferring to the University of New Mexico to pursue pre-medical studies. Bill finished college in New Mexico and went on to the University of Colorado Medical School, graduating in 1967. He pursued surgical training at the University of Minnesota, where pioneer cardiac surgeons like Richard Varco and C.
Walton Lillehei were on the faculty. Then, upon completion of a Ph.D. in Biophysics and a general surgery residency in 1974, he was invited by Dr. Aldo Castaneda to come to Boston for specialty training residencies in Thoracic and Cardiovascular Surgery at Harvard Medical School. “The rest,” as they say, “is history.”
Bill went on to make countless enormous contributions to the rapidly progressing field of surgical management of congenital heart disease. He advocated for anatomic repair of transposition of thegreat arteries in the neonatal period, recognizing the unique but limited “window of opportunity” that existed because of the innately “prepared” nature the left ventricle of newborns with TGA, and did some of the first neonatal arterial switch operations. He went on to be the lead author of one of the early Congenital Heart Surgeons’ Society studies of intermediate results after the arterial switch repair.
He pursued complete repair, rather than palliation, of more complex anomalies such as those combining interrupted aortic arch with intracardiac defects. And success was achieved, not just through technical prowess in rearranging the anatomy, but through a scientific AND intuitive approach in the operating room which included efficient use of hypothermia and of cardiopulmonary bypass, in ways that minimized its deleterious effects, based on Bill’s pursuit in the laboratory of an understanding of responses at the cellular level and the microcirculation to biochemical alterations related to anoxia and reperfusion. His care of patients in the intensive care unit was based not on a protocol but on their physiology.
Dr. Norwood’s name is known worldwide, largely in association with his personal development of staged reconstructive surgical management of Hypoplastic Left Heart Syndrome. The Stage 1 Norwood operation, once a subject of skepticism, and then of envy, is today by far the most frequently performed complex neonatal cardiovascular reconstruction. But this was much more than a technical achievement.
Bill was convinced that the well-developed right ventricle, which had supported the development in utero of a complete child, could be put to efficient use postnatally to support, for a limited periodof time, both the systemic and pulmonary circulations, while carefully controlling pulmonary blood flow so that the pulmonary vasculature was adequately protected in anticipation of eventual conversion to functionally univentricular circulation based on principles embraced by Fontan and Kreutzer in their management of patients with tricuspid atresia. His belief that conversion to the Fontan circulation should be done in phases, allowing the single ventricle to “remodel” in response to the initial change in loading conditions before completing the total cavopulmonary connection remains the basis for successful management of single ventricle anomalies to this day.
The lives of literally tens of thousands of families in all parts of the world have been touched by Bill’s contributions.
Many thousands were direct recipients of Bill’s outstanding care, having benefitted directly from his incomparable surgical skill and his genius in harnessing the fundamentals of cardiovascular physiology to optimize the outcomes from surgical therapies. Many, many more were beneficiaries of Bill’s gifts, through the work of countless other surgeons, cardiologists, anesthesiologists, nurses and others whose careers were directly impacted by his teachings, his mentorship, and the advanced understanding of congenital heart disease that he promoted.
Bill’s belief in his patients, and in the “life force” that motivates a small baby to go on living despite the enormous burden of abnormal circulatory physiology, enabled Bill to face challenge after challenge, and to create one solution after another. Bill liked to quote the late Theodore Levitt, former professor at the Harvard Business School and editor of Harvard Business Review, who said:
‘‘Creativity is thinking up new things.
Innovation is doing new things.’’ We are all indebted to Bill Norwood for having the Curiosity, Determination and Genius that it takes to Think Up New Things…. for the Empathy, Faith and Courage that it takes to Do New Things….And For the generosity to use those gifts toimprove
so many,many lives.
Marshall Jacobs, MD
Johns Hopkins School of Medicine