January 21, 2021
Image credit : Representative Image
Eight out of every 1,000 newborns in this world can have some form of congenital heart defects. About 25% of them can be critical and life-threatening in the newborn period itself. These patients have to be diagnosed and treated as soon as possible.
Here, we present the story of a three-day-old child born in Palakkad, brought to our hospital in a very sick state with breathing difficulty and low oxygen levels. We diagnosed the child to be suffering from a very rare and serious heart condition in which there was a discontinuity of blood supply between the upper and the lower body.
As a result, the upper body was receiving pure blood and the 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 treated at the earliest.
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 three-day-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 to the upper body blood vessel and close the big hole between the two main blood vessels of the heart. The traditional way of conducting this operation involves draining the baby’s blood, stopping the total circulation temporarily and performing the procedure. This comes with risk of damage to the brain, kidney and lungs. We had to improvise a more technically demanding strategy to ensure constant blood supply to the brain during the entire operation.
The procedure took almost six tedious hours. But the way her heart swiftly sprung back to life pumping oxygen rich blood uninterruptedly to the whole body was an instant full battery recharge for all our minds and hearts. The child recovered uneventfully and we could discharge her just eight days after surgery. Her heart is perfectly normal now. She can expect a normal life and pursue any profession that she dreams of.
Inside the mother’s womb, the normal heart forms by many closely spaced parts that join together 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, have to be diagnosed immediately after birth and treated at the earliest as any delay in the diagnosis or the treatment could be catastrophic for the newborn. Such babies, if treated on time, can expect a good recovery and normal life. 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 at PSG hospitals, Coimbatore.