Extremely complicated Rastelli procedure saves the life of a baby boy

Today, congenital defects of the heart in children are very common. Heart defects in children can be minor or majorand while some can be cured with one single surgery, others require series of procedures for complete recovery. Recently, a five-year old child who had a serious condition of cyanosis and a history of congenital defects was admitted to CK Birla Hospitals BMB under the care of Dr. Manoj Daga – Senior Consultant Cardiac Surgery. Dr. Daga describes how the little boy becoming blue due to his cyanotic heart defect and explains that this condition is commonly known as Blue baby syndrome. The baby didn’t have well-formed pulmonary artery whose primary function is to supplyblood to the lungs. Also, in his case the pipe entered the right ventricle blindly and there was no artery supplying blood to the lungs.

Undoubtedly the child had a very critical heart defect whose only solution was to get operated. He had an operation when he was 6months old, wherein one small pipe connecting the heart and the lungs were attached so that flow of oxygen improvedand blood flowed seamlessly into the heart. However, with time the child had overgrown that pipe which was again blocking the flow of blood. This time his pulmonary artery had become very narrow. This child required creation of a new pipe wherein a passage and growth would take place between right and the left pulmonary artery. Hence, a new pipe conduit was joined from the bifurcation. With this procedure the right and left pulmonary junction which had the blind right ventricle with a hole in the heart, had to be closed for complete recovery.

Dr. Daga chose Rastelli Procedure for this operation. This is one of the surgeries used to treat patients with transposition of great arteries, ventricular septal defect, and left ventricular outflow tract obstruction. Before the surgery, common pre-operative tests like electrocardiogram, echocardiogram, chest X-ray and blood testing were done on the child. Dr. Daga and his cardiac team made surethat the child was fit for operation and he had ample chances of complete recovery. Post-operation the patient was shifted to Intensive Therapy Unit in stable hemodynamic condition wherein he was given exhaustive post-operative care. Within two weeks, he went back home with a fresh lease of life. Nevertheless, he will have to re-visit in next 15-20 years for another surgery. The pipe which has been putat present matches up to the requirement as per his age. When he is 20-25 years old, the current pipe must be upgraded again to a bigger pipe.

In conclusion, Dr. Daga says, “Rastelli Procedure in paediatric cases is a very rigorousand high precision surgerythat has been rarely done in eastern India. The child was suffering from congenital blue baby syndrome whose only solution was operation. Despite many complications, we ensured that he went back home after complete recovery and now leads a normal life like anyone else.”