When Anandarohini brought her seven-year-old son to the city, miles away from her village in Coimbatore, for treatment of a tumour in his heart, little did she know he would get a new lease of life.
Sivavignesh, who was taken for surgery to remove a 5-cm tumour mass, came out several hours later with a new heart.
Rarest of rare case
For doctors at Madras Medical Mission (MMM), Sivavignesh’s case is one to remember for a long time. In India, only four children below the age of 12 have undergone heart transplants.
“The boy had a large tumour on the left ventricle heart muscle. The left side is important as it pumps blood to the rest of the body. When we diagnosed him, we found the tumour occupied half of the left ventricle,” said K. Sivakumar, chief paediatric cardiologist at MMM.
Hoping it was benign tumour, surgeons took the boy in for surgery.
“When we began operating, we found the tumour had infiltrated the heart. We took a biopsy and, in an hour, found it was highly malignant and cancerous. If we removed the tumour, the heart would lose its function,” said Ejas Ahamed Sheriff, senior consultant paediatric cardiac surgeon.
Dr. Sivakumar said the tumour could have been removed completely only through extensive resection but it would leave behind inadequate heart muscle to pump blood for maintaining circulation.
The boy was hooked to a heart-lung machine and doctors decided to look out for a donor heart and approached the cadaver transplant programme of the State government.
It was at the same time a 15-year-old boy was declared brain dead at Sri Ramachandra Medical College.
“Usually, we follow the listing in the transplant registry. But in this case, there was no time. The programme convener informed us about the donor and a medical team rushed to the hospital to harvest and bring back the heart,” Dr. Sivakumar said.
Again the challenge was in racing against time — the boy had been on the heart-lung machine for 10 hours and the donor heart could only be harvested last, after all the other organs — liver, cornea and kidneys — were taken out, as the body needs a beating heart and blood circulation to keep the organs viable.
Roy Varghese, senior paediatric cardiac surgeon, harvested the heart. “We reached MMM with the heart in about 30 minutes. It was around 9 p.m. then,” he said.
Dr. Sheriff completed the transplant by 11.30 p.m. Within 12 hours, the child was able to breath without ventilator assistance and started on oral fluids.
“It was an unplanned transplant. The donor blood and heart size were a match for the boy. A cancerous tumour in the heart is a rare condition. The four children, across the world, that underwent heart transplants suffered from dilated cardio myopathy,” he said.
The boy will now be on immuno-suppression drugs to enable the body to accept the organ.
Sivavignesh’s parents — Anandarohini and Thankaraj — said their son was doing well after surgery. Thankaraj works in an automobile store.
They said the boy was first taken to hospital after his heart beat became very prominent and obvious. “We took him for a check-up and doctors said the abnormality was because he was very lean. Later, a hospital in Coimbatore diagnosed him with tumour but asked us to wait for a year. We decided to come to Chennai but had no clue the tumour was cancerous. My son has got a new life now,” said Anandarohini.
The family paid nearly Rs. 2.5 lakh towards the surgery. The hospital will decide on whether to financially support them if they are unable to organise funds further.