Doctors at a hospital in Parel have successfully performed the Hybrid Norwood surgery, a complicated procedure, on Avantika Nair, an 11-day-old baby girl from Kalyan, who was born with an underdeveloped heart that was smaller than the size of a lemon.
Avantika was suffering from a rare heart condition called hypoplastic left heart syndrome, which was detected when she was still in the womb. Her mother, Dhanya Nair, an accountant, was only five months pregnant when a doctor she consulted in Kalyan suspected the defect during a pregnancy scan and referred her to Nowrosjee Wadia Maternity Hospital. Doctors at the hospital said that this was the first such procedure to be performed in western India. Only two of the four chambers of Avantika’s heart were functioning owing to the defect. Only one in 10,000 babies are born with the syndrome, which affects blood flow to the body as the left side of the heart is underdeveloped. While most children die before the defect is detected, one in one lakh children are diagnosed with the condition, and one in 10 lakh receive treatment.
Detected in the womb
Dr. Shreepal Jain, paediatric interventional cardiologist, said, “It is rare for the defect to be detected in the womb. Early diagnosis helped us plan the interventions in advance.” Ms. Nair delivered Avantika on September 22 in her 34th week of pregnancy. Avantika was immediately shifted to the neonatal intensive care unit at B.J. Wadia Hospital for Children and taken in for surgery on October 2. Dr. Jain said, “She weighed just 2 kg at the time of the surgery. We gave her medication to retain the flow of blood to the body. The surgery created a bypass channel to optimise blood flow.”
Dr. Biswa Panda, paediatric cardiac surgeon, said the five-hour-long surgery was challenging as they were not sure if Avantika would be able to endure the procedure. He said, “Babies are born with a heart that is the size of a lemon. In this case, the heart was much smaller due to premature birth and the defect.” The surgery involved three procedures: stenting to help the heart pump blood to the body, banding to control blood flow to the lungs and ballooning to reduce pressure on the left side of the heart.
Dr. Panda said the baby’s chest had to be left open after the surgery as the heart began to swell. Avantika also suffered a cardiac arrest and had to be put on an extracorporeal membrane oxygenation machine for more than 24 hours. Her condition later stabilised.
Ms. Nair said that the surgery cost them ₹3.6 lakh, but the hospital waived ₹50,000 from the bill. She said, “We have exhausted all our money. Now we will start saving for her next surgeries.” Avantika, who is two months old now, will have to undergo two more surgeries to completely correct the defect.
She will have to undergo a surgery when she is six months old to channel impure blood from the upper half of the body to the lungs, and another surgery at four or five years of age to channel impure blood from the lower half of the body to the lungs.
