Transfusion-free arterial switch operation in a 1.7-kg premature neonate using a new miniature cardiopulmonary bypass system

In cardiac surgery, the potentially detrimental effects of transfusions on patient outcome are increasingly appreciated. Therefore, at our institution there are continuing efforts to modify our surgical, perfusion, and blood management strategies with the aim of transfusion-free cardiac surgery even in neonates and small children. Stringent improvement of these strategies, particularly the downsizing of the cardiopulmonary bypass system, have now enabled a transfusion-free arterial switch operation in a 1700-gram prematurely born neonate.