Abstract
In premature, very-low-birth-weight (VLBW) neonates, complex cardiac malformations
can be successfully repaired under conditions of cardiopulmonary bypass. However,
due to the immaturity of organ Systems, these patients are exposed to a specific risk
resulting from noxious effects of extracorporeal circulation, especially on the central
nervous System. Two premature neonates with low and very low birth weight of 1160
g and 1650 g, were operated on using cardiopulmonary bypass for severe pulmonary artery
stenosis and truncus arteriosus communis type II, respectively. The neonate with pulmonary
valve stenosis survived, but at 2-year-follow-up examination motoricity retardation
as a result of cerebral immaturity-related changes was evident. The other neonate
died suddenly on the fifth postoperative day of a massive intracranial haemorrhage.
Due to the fact that the natural history of VLBW children is a priori characterized
by a high incidence of major neurological handicaps, open heart surgery may by improving
survival chances contribute to an increased incidence of mentally handicapped children.
Key words
Very-low-birth-weight neonates - Open heart surgery
