Bravehearts of the Foundation: Baby of Hajara
November 1, 2018 | Contributed by R Srivatsan
Born to Hajara and Sadath of the Kozhikode district in Kerala, this baby boy was the third child of the family. However, even before the parents could rejoice at his arrival, it was discovered that he faced a tough journey ahead of him because of his heart.
Symptoms of congenital heart disease were identified while it was still only his second day in this world. Though otherwise born at a normal weight of 2.6 kg, baby of Hajara spent the next five days under observation in the ICU. He was then sent to the Intermediate Medical Care Unit (IMCU) for special pediatric care.
The doctors performed a detailed echocardiography and confirmed that the baby was suffering from Transposition of the Great Arteries (TGA) and a moderate sized subpulmonic Ventricular Septal Defect (VSD). TGA meant that the two main blood vessels in the baby’s heart – the aorta and pulmonary artery – arose from the wrong chambers. And, VSD meant that the lowers chambers of his heart had a hole between them.
The fact that this few days old baby suffered from two rare heart disorders at the same time made his case even more critical and shattering. For apt care, he was brought to the Amrita Institute of Medical Science (AIMS), in Kochi where the doctors performed thorough diagnosis and concluded that they immediately needed to perform an Arterial Switch Operation (ASO) along with a VSD closure and aortic arch repair on the baby’s heart.
The news of such extensive surgery came as a wave of shock for the baby’s parents. Not only were they deeply worried about his health, but their meager income of Rs. 5000 a month made the expenses of the costly surgery seem unimaginable. However, with our financial support, the arrangements for his care were made, just in time.
The baby went through an intense surgery. The procedure began after the Cardiopulmonary Bypass (CPB) system was established through aortic & bicaval cannulation to support the functions of the heart and lungs during the surgery. The heart was cooled to 24-degree Celsius through cold blood injection and aorta was cross-clamped to separate the systemic circulation of the heart from its outflow.
The VSD was then closed using a treated autologous pericardial patch, obtained from the membrane enclosing the baby’s heart. Post this the aortic clamp was repositioned to allow circulation only through the innominate artery. The aortic arch was also repaired by incising its entire undersurface, after clamping the descending thoracic aorta and removing all ductal tissue. Clamps were released and circulation to the entire body was reestablished.
After the VSD closure and aortic arch repair, the doctors performed the ASO by dissecting the aorta and pulmonary artery. They augmented the coronary buttons to the neo-aorta and an autologous pericardial patch to the neo-pulmonary artery. Next, de-airing of the heart was done and it was rewarmed to the normal temperature. The procedure was completed by closing the heart and the chest in layers, following which, the baby recovered slowly.
The surgery has helped restore a normal heart function and blood circulation for this baby who battled with life-hreatening heart conditions while he was still only a few days old. Though the care so far has been complex and meticulous, it has helped build a strong foundation for his healthy and bright life ahead.