CARDIAC-SURGERY FOR PEDIATRICS - PERIOPER ATIVE MANAGEMENT WITHOUT THE USE OF BLOOD OR BLOOD-COMPONENTS IN SMALL CHILDREN

The refusal blood transfusions for personal or religious reasons espec ially for children whose parents are Jehovah's Witnesses puts physicia ns in a moral dilemma. On the one hand early corrective surgery is exp ected to decrease the incidence of chronic complications in congenital heart disease. On the other hand - besides surgical bleeding - hemodi lution effects due to cardipulmonary bypass circuit push human physiol ogy at this age to its limits. We wanted to discover wether, it is pos sible to carry out open-heart-surgery without the use of any blood or blood-products, and can report about the successful complete repair in two small children (6000 g and 8 100 g) with M. Fallot, whose parents are Jehovah's witnesses.