On the night of 11th January, a three-day old baby was brought to PSG hospitals by her apprehensive parents. The baby was delivered at a hospital in Palakkad.
The doctors there noticed severe breathing difficulty, and after examining the child, they told the parents that their baby could be suffering from a serious heart defect needing urgent heart surgery and the child should be shifted to a higher centre.
At PSG hospitals, the senior consultant pediatric cardiologist Dr. Vinoth Doraiswamy, diagnosed the child to be suffering from a rare and serious heart condition named Interrupted aortic arch + aorto-pulmonary window.
He said “It is a developmental defect in which the blood vessel (aorta) supplying pure blood to the body is incompletely formed and as a result, the upper body was receiving pure blood and lower body was receiving impure blood. In addition, there was a large hole between the two major blood vessels exiting the heart. This led to significant hypertension in the lungs. This is a life-threatening condition which can be fatal if not operated at the earliest”.
Dr. C. Ananthanarayanan, senior consultant Cardiothoracic and Vascular surgeon said “From the time the diagnosis was made, it was a race against time as the child was very sick when she presented to our hospital. Operating on a 3 days old baby poses significant technical challenges.
New born heart is just the size of a lemon and the margin of error in such a complex procedure is practically nil. We had to reconnect the lower body blood vessel (descending thoracic aorta) to the upper body blood vessel (arch of aorta) and close the big hole between the two main blood vessels of the heart (aorto-pulmonary window).
The traditional way of conducting this operation involves draining the baby’s blood, stopping the total circulation temporarily (Deep Hypothermic Circulatory Arrest) and to perform the procedure. We used a more technically demanding strategy (Antegrade Cerebral Perfusion) to ensure blood supply to the brain during the entire operation. The procedure took almost 6 tedious hours.
The child recovered uneventfully and we could discharge her just 8 days after surgery. Her heart is perfectly normal now. She can expect a normal life, go to school, college and pursue any profession that she could dream of”.
He also added “Inside the mother’s womb, the normal heart forms by many closely spaced parts that join in a peculiar order like solving a jigsaw puzzle. Understandably, there are many different permutations and combinations in which this can go wrong leading to a wide spectrum of heart defects ranging from very mild to complex and life-threatening problems.
Critical heart conditions, like in our patient, must be diagnosed immediately after birth, and treated at the earliest as any delay in diagnosis or treatment could be catastrophic for the newborn. In the current era, almost all varieties of congenital heart diseases can be treated with good long-term outcomes. It is important for the parents and treating physicians to recognize any abnormal symptoms and refer to a higher cardiac center for immediate treatment. All complex congenital heart surgeries are being done in PSG hospitals, Coimbatore”.