Fourteen-year-old Chandran had to squat to regain his breath due to multiple congenital heart defects. His rare heart condition was diagnosed and managed at Jipmer until five years ago. Last month, he was referred to the Rajiv Gandhi Government General Hospital (GGH).
His tongue, face and fingernails had turned blue, though his haemoglobin count was 18.5 gm (the normal count is 13.5 gm). Doctors feared complications such as brain abscess or stroke. At the GGH, the boy underwent a range of investigations.
Scans showed ventricular septal defect and an overriding aorta. The pulmonary valve had an obstruction. The right ventricle had enlarged severely and the blood pressure in his lungs was high. Stumped by the case, the doctors wondered how he had survived so long.
However, after a difficult but successful surgery, Chandran, the son of an agricultural labourer from Parithipuram in Villupuram district, is all set to start his life anew. A Class VIII student at a government school, he will return home and lead a normal life.
“When we opened up his heart we found the aorta and pulmonary artery emanated from the right ventricle, a unexpected complication,” said cardiothoracic surgeon K.S. Ganesan, who led a 10-member team that performed the open-heart surgery on October 5.
“Normally, the aorta that carries oxygenated blood originates in the left ventricle and the pulmonary artery, which carries deoxygenated blood to the lungs, originates in the right ventricle. We created a bidirectional shunt in the superior vena cava that would take blood to the lungs. We also did an atrial spetectomy (made a hole between the two atria to lower pressure on the ventricles) with Azygos (vein) litigation, thus providing an alternative path for blood to flow into the right atrium,” Dr. Ganesan explained. These procedures reduced the pressure on the right ventricle. “We did not consider relocating the aorta into the left ventricle as it is a complicated procedure and the patient could die,” the surgeon said.
Dean V. Kanagasabai said the surgery could have cost Rs. 4 lakh in a private hospital. “He has been in the hospital for over a month and that would also cost money,” he said. The surgery was done free of charge under the Chief Minister’s comprehensive health insurance scheme.