Bravehearts of the Foundation: Krishna Kumar
December 11, 2018 | Contributed by R Srivatsan
Ten-month-old Krishna Kumar, is the only child born to Indu Kumari and Ajay who hail from Bettiah in Bihar. When the baby reached his six-month milestone, he got extremely sick and was rushed to a District hospital, where the pediatricians diagnosed pneumonia. This was not all, the Doctors even detected a murmur which was naturally a huge cause of concern for the family and the doctors.
Indu and Ajay were asked to take their little boy to Delhi for further evaluation, but they were at a complete loss. They were a simple family, with very limited exposure, especially to such situations. They decided to give it time, and in this time, Krishna didn’t get any better – in fact he got frequent bouts of pneumonia. Indu cried many tears of frustration, seeing her son suffer, knowing that they just didn’t have the funds or means to take him anywhere.
On 2nd October 2018, Amrita Institute of Medical Sciences, in Kochi organized a screening camp in Patna along with Rotary. A friend of Ajay who had seen the family suffer suggested that they take their son as he wasn’t getting any better.
They went to the camp and Krishna Kumar was recommended an Echo, where the Congenital Heart Defect was evaluated, it was a complex case – an AV Canal Defect. In this particular disorder, there are two holes (an Atrial Septal Defect and Ventricular Septal Defect) and instead of two valves, there was only one.
He needed urgent intervention, an open-heart surgery. Again, the family were left between a rock and a hard place, as even though the diagnosis was clear and their son’s life was critical, they did not have the money to pay for the surgery. Ajay is a labourer who earns approximately Rs 5000 per month. Such high medical costs were unimaginable for him.
But with the support from Rotary officials, the family’s travel to Kochi was funded – and we at Genesis Foundation supported the surgery costs.
The parents could finally breathe a sigh of relief! Krishna Kumar was wheeled in for surgery! He recovered well, and the family returned to Bihar to start their life together again, this time with good health, gratitude and happiness.
Surgery Procedure :
Median sternotomy done. Right lobe of thymus excised. Pericardium harvested and kept for tanning. Pericardial stays taken. Heparinised, aortobicaval cannulation, on CPB. Cooled to 24 degree centigrade. PDA ligated. Root plegia, Aorta cross clamped. Antegrade blood cardioplegia given. Heart arrested. SVC and IVC snared. RA opened. LV vented through the ASD. VSD identified. VSD closed with treated autologous pericardial patch using continuous prolene sutures with upper end of the patch attached to the bridging leaflets to separate the two AV valves. ASD patch attached the AV valves at the level of VSD patch. Mitral valve papillary muscle split to create two heads. Cleft partly closed. MV opening accepting 12 Hegars (N=12.6). No MR on saline test. ASD closure completed and a 4 mm fenestration created in the patch. TV tested- no TR. Deairing of the heart was done. Aortic cross clamp released. Heart picked up in sinus rhythm. RA closed. Rewarmed, came off CPB in first attempt. TEE- Mild – moderate MR along the posterior annulus. Went back on CPB and ACC and RA opened after plegic arrest. ASD patch opened and mitral valve inspected. Posterior annuloplasty done over a limited area of the annulus. No MR on saline test. ASD closure completed and a 4 mm fenestration created in the patch. Deairing of the heart was done. Aortic cross clamp released. Heart picked up in sinus rhythm. RA closed. Rewarmed, came off CPB in first attempt. TEE- mild MR, no TR, good ventricular fn., no residual VSD, no LVOTO. MUF done, decannulated. Protamine given. Hemostasis achieved. Routine chest closure over drains and pacing wires. Ht. 71 cm, wt. 5 kg, BSA 0.31 m2.