Cardiac Surgery

Bangalore Conducts Intracardiac Tumour Surgery on 3-month-old

The baby boy presented with symptoms of respiratory distress when he was brought by his parents to BGS Global Hospitals

The child with his mother

BGS Global Hospitals, Bangalore successfully performed surgery on a 3-month-old infant for removal of rare heart tumour. The surgery, performed by a team of three cardiac surgeons Dr Bharat Dubey, Dr SP Manoj and Dr Anand Subramaniam along with cardiac anaesthetist Dr Srinivas Dhulipalla, lasted about four hours.

The baby boy presented with symptoms of respiratory distress when he was brought by his parents to BGS Global Hospitals. A murmur of the heart was heard on examination of the baby which propelled the cardiologists to carry out an X-ray of the chest and ECG with a 2D Echocardiography. These revealed a massive tumour in the right ventricle of the heart. This condition is known as Rhabdomyoma.

The heart of just the size of his fist had a tumour of size 3.5 cms length, 4 cms breadth, 2.5 cms thickness occupying almost the entire right ventricle (pumping chamber) of the heart. More than 85 per cent of the right ventricle was occupied by the tumour obstructing the flow of impure blood to the lungs where it gets purified. The baby was hence not receiving enough oxygenated pure blood to all parts of his body. This may lead to backlogging of the blood in the liver due to right heart failure, which if untreated is fatal. Because of this obstruction, 33 per cent of these infants die within the first week of birth. Eighty per cent of them don't make it to their first birthday.

Said Dr Bharat Dubey, Consultant Cardiac Surgeon, BGS Global Hospitals, "Intracardiac tumours in infants are very rare. The frequent one which is rhabdomyoma has an incidence of one in 17, 000. After a thorough medical literature search, only two cases of rhabdomyomas affecting the right ventricular body and sparing the inflow tricuspid valve as well as the outflow pulmonary valve are reported."

During the surgery, the heart of the baby was stopped and the blood diverted to a heart lung machine. The tumour was approached through incising the right atrium and was completely removed through the tricuspid valve. "The long-term results of such a surgery is good. The baby was in the ICU for 48 hours on ventilator support. He was shifted to the ward after a week and is progressing well," Dr Dubey added.

About Rhabdomyoma

In an infant an intracardiac tumour which is not multicentric can be most probably rhabdomyoma, fibroma, myxoma, haemangioendothelioma. Rahabdomyoma is the commonest and unfortunately 60 to 86 per cent of these children have an associated neurological disease known as tuberous sclerosis.

Rhabdomyoma is a benign tumour but is lethal due to its presentation and infrequent diagnosis. The child can present with obstructive flow of blood, pressure effects of the tumour, arrhythmias, convulsions etc. If diagnosed correctly and properly removed under cardiopulmonary bypass the patient recovers and does well.

EH News Bureau