Wednesday, Sep 15, 2004
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By M. Dinesh Varma
The Pakistani boy, Shabaz Tariq, who was operated on for closure of a ventricular septal defect, recuperating in Frontier Lifeline Hospital in Chennai.
CHENNAI, SEPT. 14. A Pakistani boy who was advised by Karachi doctors to seek treatment in North America has got a new lease of life in a Chennai-based cardiac centre where nitric oxide imported from France was used to lower his lung pressure during post-operative management.
Fifteen-year-old Shahbaz Tariq was operated on for closure of a ventricular septal defect (VSD) and patent ductus arteriosus (PDA), due to which blood got mixed in both chambers of the heart. The surgery was performed by a team led by K. M. Cherian in the Frontier Lifeline Hospital.
It could not have been attempted without nitric oxide, Sanjay Cherian, Clinical and Administrative Coordinator, said. The hospital stocked nitric oxide, critical for managing several cases of high lung pressure, he said.
The patient was subjected to cardiac catheterisation and his pulmonary pressure measured before doctors went ahead with the surgery. Gas along with oxygen was administered through the respirator to lower pulmonary pressure, which remained high in the post-operative phase. As a precaution, the patient was kept in an intensive care unit for four days. "Though the procedure is common, it is very rarely attempted on a grown-up child as the lungs would have fixed changes by then and the risks would be much higher," Snehal Kulkarni, paediatric cardiologist in the hospital, said.
Commonly, VSDs were diagnosed at birth and surgery was performed within six months or one year. Surgery on infants did not require nitric oxide back-up. In over 50 per cent of the cases involving grown-up children, surgery was ruled out, Dr. Kulkarni said.
Hole in the heart
Shahbaz was born with a hole in the heart which his parents thought would `heal on its own' as the boy grew up. However, when he began going to school, he started suffering bouts of breathlessness at the slightest effort and often complained of chest pain.
In 2002, doctors in the Prince Aga Khan Hospital in Karachi advised him to go to North America as surgery was risky and required to be undertaken only in a modern hospital with nitric oxide and extra corporeal membrane oxygenator facilities. This was the boy's "only chance short of heart double lung transplantation," the doctors wrote.
Unable to afford a trip to the U.S., the boy's Hyderabad-based maternal uncle, M. A. Rahim, began looking for a hospital with the facilities in India. "It came as a surprise that many modern hospitals I contacted in India did not stock nitric oxide," said Mr. Rahim, who is coordinating the return of Shahbaz and his mother, Nafisa Tariq, on Wednesday.
Shahbaz hopes to graduate from video games to real sport as soon as he gets his doctor's approval.
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