Congenital defects of the heart in children are very common in contemporary times. Heart defects can be minor or major in children. While some can be cured with one single surgery, others require a 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 – BM Birla Heart Research Centre. He was admitted under the care of Dr. Manoj Daga – Senior Consultant Cardiac Surgery – BM Birla Heart Research Centre. Dr. Daga describes the little boy becoming blue due to his cyanotic heart defect. This condition is commonly known as Blue baby syndrome. The baby didn’t have a well-formed pulmonary artery whose primary function is to supply blood 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 and the only solution was to get operated. He was already operated upon earlier, when he was just 6 months old, wherein one small pipe connecting the heart and the lungs were attached so that the flow of oxygen improved and blood flowed seamlessly into the heart. However, with a passage of time, the child had overgrown that pipe which was again blocking the flow of blood. This time his pulmonary artery had become very narrow. The child required the 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. Rastelli Procedure is one such surgery where patients with transposition of great arteries, ventricular septal defect, and left ventricular outflow tract obstruction are treated. 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 sure that the child was fit for operation and he had ample chances of complete recovery. Post-operation the patient was shifted to the Intensive Therapy Unit in a 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 the next 15-20 years for another surgery when his pipe will be upgraded to a bigger one. The pipe which has been put at present is the one which matched up to the requirement as per his age.
In conclusion, Dr. Daga says, “Rastelli procedure in paediatric cases is a very rigorous and high precision surgery that 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 goes back home after complete recovery and leads a normal life like anyone else.”
Dr. Manoj Daga, Senior Consultant Cardiac Surgery,
CK Birla Hospitals – BM Birla Heart Research Centre