Giving 11-year-old Ayesha Sadiq from Africa a chance at leading a normal life, doctors at the BLK Super Speciality Hospital here have successfully performed a rare open heart surgery on the child who has sickle cell disease.
“What made this surgery more complex was the exchange transfusion performed by the doctors in two minutes prior to the open heart surgery. The child is now doing well and has been discharged,” said senior consultant of cardiology at BLK Heart Centre Neeraj Bhalla.
According to doctors at the hospital, when Ayesha was admitted about a month ago, she was diagnosed with pulmonary valve stenosis or disorder of the heart valve where outflow of the blood from the right side of heart is obstructed at the level of the valve. “We had to take a chance to do valve dilation (valvuloplasty) with the associated risk of blood clotting, caused by sickle cell disease. Initially we consulted the Haematology team and decided to take her up for valvuloplasty and a unit of fresh blood was transfused the previous night to replace some of the abnormal blood with normal haemoglobin blood, to reduce the chances of clotting,” said Dr. Bhalla.
Despite the fact that the procedure was carried out without any complications, the result was not too satisfactory, said the doctor.
“We realised that the child probably had a major obstruction just above the valve, which is a very rare cause of pulmonic stenosis. This led to the possibility that the child probably would now need open heart surgery to correct the defect. This was riskier as it carried a higher threat of blood clotting due to the sickle cell disease of the child,” said Dr. Neeraj.
Giving details of the surgery, senior consultant Sushant Srivastava said: “A meticulous plan to exchange her entire blood volume in the operating room just prior to the open heart repair of her heart defect was made. To prevent mixing of the two types of blood, this had to be done rapidly. Open heart surgery then proceeded in routine fashion and recovery was uneventful.”
“Correct evaluation of the problem was critical in management of this patient. Also post operative evaluation suggested very successful reduction of the obstruction and the child made a smooth recovery thereafter,” added Dr. Srivastava.