Rare cardiac surgery done on a ten-day-old infant

EHM News Bureau - Mumbai

In a rare cardiac surgery, a ten -day old child born with transportation of great arteries (TGA) was operated successfully by a team of surgeons at the Asian Heart Institute and Research Centre (AHIRC). The seven hour surgery was conducted under the guidance of pediatric surgeon Dr Ramji Mehrotra.

Said Dr Mehrotra, “When the infant was rushed to AHIRC from Nashik, it was just five days old and suffering from jaundice. Its body had turned blue and it was gasping for breath. The surgery was a success because of dedicated team and set-up.” An echocardiography revealed the baby suffered from the congenital heart defect -TGA. In TGA while the aorta rises from the left side of the heart and supplies oxygen to deficient blood to the body, the pulmonary artery rises from the right and supplies oxygenated blood to the lungs.

For a normal person, the position of aorta and pulmonary artery are the reverse. The branching of right coronary artery into two and the unbranching of the left further aggravated the supply of bad blood to the body. “The baby was surviving because of a hole in the heart, which allowed the mixing of the blood,” said Dr Mehrotra. The surgery involved cooling the baby in 20 degree centigrade in heart-lung machine, stopping the heart for two to three hours and then performing the arterial switch-over-cutting and re-positioning a section of the aorta and pulmonary artery to the right and left side respectively. In India around 5,000 to 7,000 babies are born with TGA every year. “If the baby undergoes surgery within one week, the chances of survival is 30 per cent and within five months, it is 70 per cent. The baby needs to undergo the corrective surgery with in 10 months.”

Dr Mehrotra rued that only one per cent of such babies receive treatment because lack of awareness about the treatment in the common populace and the medical fraternity alike.

This was not the first TGA surgery performed by Dr Mehrotra. He performed as many as 45 corrective TGAs per year at the Boston Children Hospital and Havard Medical College, before joining AHIRC eight months back. “This is the rarest of the rare operations done in India and probably the first one in the western part of the country. Doctors are generally nervous to conduct such an operation when the baby is so young” said Dr Aashish Contractor, AHIRC.