Conventional management of low birth weight and very low birth weight neonates was
composed of deferring corrective surgery by aggressive medical management or palliative
surgery which does not require cardiopulmonary bypass. However, while waiting for
weight gain, these neonates are at risk for various comorbidities. In the current
era, this “wait and let the baby grow” approach has not been shown to result in better
clinical outcomes. Early primary repair hence has become the standard strategy for
congenital heart disease requiring surgery in these neonates. However, there still
exist some circumstances, which are considered to be unfavorable for corrective surgery
due to medical, physiologic, surgeon’s technical and institutional-systemic factors.
We reviewed the recent literature and examined the reasons for delaying or not delaying
surgery.
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