Rare life-saving surgery saves newborn at Aster MIMS

09 September 2016

Kozhikode, September 9, 2016: Life had almost come to a standstill for the expectant parents. An antenatal echocardiography during the pregnancy had showed multiple birth defects in the fetus. When the doctor explained to them about the difficult combination of ‘Transposition of the Great Arteries with long segment Esophageal Atresia’, the seriousness of the birth defect had hit the parents hard.

Transposition of the great arteries (TGA) is a congenital heart defect that occurs when the positions of the two main arteries going out of the heart, the pulmonary artery and the aorta, are switched, or “transposed”. In TGA, because the main connections are reversed, the pulmonary artery which now arises from the left side carries oxygen-rich blood returning from the lungs back to the lungs. The aorta, which now arises from the right side carries oxygen-poor blood back out to the body. As a result, there is too little oxygen in the blood that is pumped from the heart to the rest of the body. Added to this was the presence of Esophageal Atresia where the esophagus or food pipe ended in a blind pouch instead of connecting to the stomach. As a result the baby can not feed and the saliva from mouth enters in the lungs, endangering the babies life.

Things came to a head when fetal distress lead to a premature delivery by emergency caesarean section at 37 weeks of pregnancy. The birth weight of 2kg compounded the complexities of the situation. A team of doctors at Aster MIMS led by Paediatric Cardiac Surgeon, Dr. Biswa Ranjan Panda and Paediatric Surgeon Dr Abraham Mammen, performed a series of surgeries to repair the two complicated anatomical abnormalities. As a planned multidisciplinary approach, on the second day of life, a cervical esophageal fistula was created to circumvent the ‘esophageal atresia. The transposed great arteries were surgically switched and corrected when the baby was seven days old. A week later Feeding gastrostomy was done for the nutritional support of the baby.

On discharge, the family was trained for feeding her through the gastrostomy tube. The baby is growing well and now reached 3.5kg weight and waiting for the final stage of the esophageal reconstruction.Dr Abraham Mammen opined that such rare and complex diseases can be smoothly managed by well-coordinated multidisciplinary approach. This is the first time in Kerala a new born baby is brought back into life through such complicated and rare series of surgeries. Dr. Panda explained, with the current medical advancements, most of the congenital heart diseases are treatable, either as a single surgery or in a staged manner. Early diagnosis and timely intervention is the key to success for such situations.

Dr. Rahul Menon, CEO, Aster MIMS said, ‘A congenital birth defect brings a cost burden to the parents in addition to their worries about the child’s condition. We are happy that we could help the parents find an affordable solution. Aster MIMS will continue to provide the best world class medical care at a reasonable cost to the patients.’

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