This article shows what can be accomplished surgically, even on very low birth-weight babies, when a dedicated surgical team (in this case, led by the ingenuity of the perfusionists) is willing to go the extra mile.
The full text of this article can be downloaded FREE here: http://www.kardiotechnik.at/download...diopulmona.pdf

J. Card Surg. 2005 Mar-Apr;20(2):180-2.

Transfusion-free cardiac surgery with cardiopulmonary bypass in a 2.2-kg neonate

Hübler M, Boettcher W, Koster A, Redlin M, Stiller B, Lange P, Hetzer R.
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.


Particularly in neonates, complex cardiac surgery employing cardiopulmonary bypass normally requires the transfusion of autologous blood components. This is predominately caused by the relatively high priming volume of the circuit with subsequent extreme hemodilution. We report on a synoptic approach to avoiding transfusions in a 2.2 kg neonate with scheduled for correction of an intracardiac total anomalous pulmonary venous connection to the coronary sinus and a persistent foramen ovale. In this patient with a preoperative hemoglobin value of 16.5 g/dL, minimization of the cardiopulmonary bypass circuit, adjustment of the perfusion technique and strict reduction of blood sampling resulted in complete avoidance of transfusions during the entire course of the operation while maintaining safe hemoglobin levels, which never fell below a concentration of 8 g/mL.

PMID: 15725146 [PubMed - indexed for MEDLINE]