Cardiac surgery for premature and low birth weight neonates.

Congenital heart defects in low birth weight infants are typically managed with supportive therapy or palliative surgery and definitive repair is delayed. However, the morbidity of this approach has been shown to be high. At the University of California San Francisco, our approach to these infants has been one of complete repair in the neonatal period or as early as possible. Since 1992, 116 neonates and infants under 2,500 g underwent complete repair of simple and complex cardiac defects using cardiopulmonary bypass and circulatory arrest was avoided in the majority. Actuarial survival was 80% at 1 year. Noncardiac abnormalities contribute significantly to perioperative and late morbidity and mortality. Reintervention rates are comparable to other neonates. Our data suggests that complete repair of simple and complex congenital heart defects can be performed safely and effectively in premature and low birth weight infants.