Mumbai: A 3-year-old child who underwent a cardiopulmonary bypass (a rare surgery where the heart is arrested artificially) at the Sir HN Reliance Hospital last month has been discharged after 15 days. The child was suffering from a complex C-Transposition of great arteries and had to undergo redo-sternotomy, a double switch operation that involves correcting atrial as well as the arterial switch. The 16-hour-long surgery also included de-banding of the main pulmonary artery, reconstruction of neo aortic root, augmentation of the atrial cavity and bidirectional Glenn.
Isolated “transposition of great arteries” means the connection of big arteries is wrong or inappropriate and it has to be corrected by an arterial switch operation. In C-transposition, connections of atria to ventricles as well as great arteries are wrong. These abnormal hearts have a high chance of failure at an early age.
According to doctors, the child has a complex heart disease called CTG (corrected transposition of great arteries). “This is an extremely rare condition. It is seen in one out of 10,000 or even less than that. The baby came to us around four to six months ago. He is from Karnataka,” said a doctor.
Dr Parag Bhalgat, consultant (paediatric cardiology) at Reliance Hospital, said the child had undergone first-stage PA banding at the hospital earlier. However, the bigger challenge was to correct both the wrong connections in one surgery and take out the PA band. To accomplish this, the heart was arrested for eight hours and the baby was on cardiopulmonary bypass during that period. The complexity of surgery is unparalleled and requires a multidisciplinary team, which included a pediatric cardiac surgeon, a pediatric cardiologist, a pediatric cardiac anaesthetist and a radiologist.
“There are two places the connections are at the wrong limit so basically, this would risk the oxygenated and deoxygenated blood getting mixed. Apart from that, there was a big hole in his heart and one wall was leaky. So, it was not possible to go into surgery with a very small view. Initially, one surgery was done as at times we do small surgeries so the child can put on some weight. He was undernourished due to the heart problem too,” said Dr Bhalgat.
He concluded that the baby had a fast and uneventful recovery, is currently out of danger and ready for discharge. “A post-surgical cardiac evaluation has shown great results. The baby has put on some weight and his activity has improved. He doesn't get fatigued like he used to.”
