The baby made remarkable recovery and eventually was shifted to her mother’s bedside
Paediatric cardiac surgery team at Wadia Hospital lead by Dr Shreepal Jain, Pediatric Interventional Cardiologist, Dr Biswa Panda, Pediatric Cardiac Surgeon, Dr Vilson C, Pediatric Cardiac Anesthetist, Dr Jayashree Mishra, Pediatric Interventional Cardiologist successfully performed a complex and complicated procedure called as “Hybrid Norwood surgery” on 2 months old Avantika Nair from Kalyan who was suffering from Hypoplastic Left Heart Syndrome (HLHS). B J Wadia Hospital for children is the first hospital in all of Western India to have successfully performed such a complicated surgery.
During pregnancy Dhanya Nair was referred to Nowrosjee Wadia Maternity Hospital (NWMH) upon suspicion of heart defect in her unborn baby. For further evaluation she underwent fetal echocardiography an ultrasound test to detect heart problems in her unborn child. The report confirmed a cardiac defect called “Hypoplastic Left Heart Syndrome” (HLHS) wherein the structures of the left side of the heart were underdeveloped.
Dr Shreepal Jain, Pediatric Interventional Cardiologist said ‘It was noticed that due to a major cardiac heart defect, the baby would require immediate admission in the ICU after birth. The baby would also need immediate surgery to prevent damage to all other organs. Both the parents were counselled about the child’s condition and the need of two or more surgeries later in life to separate the blue and pink blood circulations. The mother was kept on a follow-up with close monitoring of the fetal well-being. The baby was then delivered at NWMH and immediately shifted to the Neonatal ICU at BJWHC.’
Dr Biswa Panda, Pediatric Cardiac Surgeon at Wadia Hospital said, ‘A detailed echocardiography was then performed to confirm the cardiac diagnosis. A medication drip was started to prevent closure of one of the arteries (PDA) responsible for keeping the baby alive. After a detailed evaluation and discussion by the entire team and in view of concerns of low birth weight, it was decided to perform a complex procedure on the new born called as “Hybrid Norwood surgery” on October 2, 2018.’
Dr Panda futher added ‘The procedure was performed in the Cath-lab.A balloon procedure was performed to enlarge the hole in the partition between two upper chambers of the heart. Next, the chest wall was opened, and bands were placed on both the lung arteries to restrict the amount of blood flowing into the lungs. After that, a tube was placed in the main lung artery through which a metallic stent was passed and inflated in the artery (PDA) connecting the two circulations. The chest wall was kept open in view of the high-risk nature of the surgery with the plan to close it once the baby was stable. Unfortunately, the baby’s gas exchange through the lungs deteriorated after shifting to the cardiac ICU and the heart rate and blood pressure started dropping rapidly. The surgical and anaesthesia team immediately started the resuscitation measures and decided to attach the baby to an artificial heart lung support machine (ECMO). The baby was kept on ECMO for nearly 36 hours before gradually removing the support. The ECMO support allowed the heart and lungs to recovered and started functioning normally. Ventilatory support and medicines were gradually reduced and stopped. The baby made remarkable recovery and eventually was shifted to her mother’s bed side.’
CEO of Wadia group of Hospitals, Dr Minnie Bodhanwala stated, ‘More than 800 cardiac patients have been treated successfully till now at BJWHC. It is probably the first hospital in Western India to have successfully performed such a complicated surgery. What is unique in this case is that the child was managed even before birth. At Wadia Hospital we organise a free cardiac screening camp for children, this helps in detection of congenital heart diseases and ensures in getting timely cardiac treatment. This makes Wadia Hospital an ideal maternal child healthcare setup for diagnosing and managing such complex cardiac defects.’
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