Thorac Cardiovasc Surg 1997; 45(5): 238-241
DOI: 10.1055/s-2007-1013734
Original Heart

© Georg Thieme Verlag Stuttgart · New York

Open Heart Interventions in Premature Low- and Very-Low-Birth-Weight Neonates: Risk Profile and Ethical Considerations

A. Borowski, S. Schickendantz1 , U. Mennicken1 , H. Korb
  • Department of Cardiovascular Surgery, University of Cologne, Cologne, Germany
  • 1Department of Pediatric Cardiology, University of Cologne, Cologne, Germany
Further Information

Publication History


Publication Date:
19 March 2008 (online)


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.