A 14-month-old Pakistani child successfully underwent a complex unusual heart surgery at the city’s Sir Ganga Ram Hospital.
The infant was brought to the hospital with an inability to feed properly, was having recurrent chest infections and every crawling movement was interrupted due to breathlessness. He was not able to grow, weighing only 6.5 kg at the time of admission.
Neeraj Aggarwal, paediatric cardiologist at Sir Ganga Ram Hospital said, “Our detailed work revealed that the left-sided blood-receiving chamber of the heart (left atrium) was hugely dilated, four times to the expected size [called giant left atrium], which was pressing on the nearby airway structures in the chest. Also there was a large hole between the lower chambers of heart [called ventricular septal defect], and the left-sided valve was leaking.”
Challenging surgery
Raja Joshi, chairman, paediatric cardiac surgery at the hospital said, “It was a complex and challenging surgery. To the best of our knowledge, only a few cases of giant left atrium have been reported in children below the age of two years. We operated the child in single stage, open heart surgery where hole was closed, valve was repaired and the giant left atrium was reduced in size. Available reports revealed that this was the largest size of left atrium for the age reported in world literature.”
The patient was extubated in the operating room itself by the anaesthesia team headed by Dr. Reena Joshi.
The patient was discharged on the seventh post operative day under the guidance of the paediatric cardiac surgery team.
Mridul Aggarwal, paediatric cardiologist at the hospital said, “Giant left atrium is a rare entity in paediatric population, but carries a significant mortality risk. When the left atrium increases in size, it causes complications by compressing adjacent structures such as food pipe, spine, pulmonary vessels, etc. After surgery, these complications are resolved which happened in the case of our patient.”
