Jaipur: First-of-its-kind cardiac surgery saves premature baby’s life

Jaipur: In the first reported case in the history of pediatric cardiac surgery in the world, a newborn baby was successfully operated upon at Fortis Escorts Hospital without an open-heart surgery despite many complications including premature birth, severe underweight and multiple heart defects such as the need for interrupted aortic arch (IAA) repair, PDA division and MPA banding (due to several holes in the heart).

The surgery was carried out by Dr Sunil Kumar Kaushal, director of Pediatric Cardiac Surgery and his team for six long hours.

Father Deepak Rewani with his baby Himanshu at Fortis.

Dr Sunil Kumar Kaushal said “It was indeed an impossible situation. The baby, now named Himanshu, was born just after 29 weeks (in his seventh month). It is such a premature stage that the mortality rate for babies is already almost 60%. The baby was weighting just 1.29 kg at the time of his birth. On top of all this, he had multiple heart defects. In layman terms, he had several holes in the heart, his blood flow to the lower parts of the body was interrupted and he needed many complex treatments for IAA repair, PDA division and MPA banding,” said Dr Kaushal.

An important thing to note here is that a healthy baby is born after nine months and weights around 2.5-4 kg. Besides, interrupted aortic arch is a very rare heart defect (affecting three babies per million live births) in which the aorta is not completely developed. There is a gap between the ascending and descending thoracic aorta. In a sense, it is the complete form of a coarctation of the aorta.

“In this condition, it is not advisable to perform an open-heart surgery. So, it was very confusing to decide how to proceed with the treatment. I spoke to many world-renowned cardiac surgeons and went through countless medical journals, but no solution could be found. The worst part was that an open-heart surgery to cure these complex heart defects is not advisable in this condition. The cure had never been reported across the world,” added Dr Kaushal.

According to Dr Rajeev Lochan Tiwari, the baby was restless and suffering from breathlessness when he arrived in the baby ICU of Fortis Escorts Hospital.

Team of doctors at Fortis who performed cardiac surgery of a premature baby.

Initially Dr Sanjay Kahtri, Additional Director, Pediatric Cardiology, Fortis Jaipur and his team under supervision of Dr Kaushal tried to inject fat and protein to increase the newborn baby’s weight. The baby was kept on a ventilator, but despite all the efforts, the weight didn’t improve much.

Dr Sanjay Khatri said that in his 35 years of experience he had never given anesthesia to a premature baby with 1.29 kg weight. It was very challenging.

With the consent of his family, the baby was operated upon. The challenging part was to coordinate surgery, anesthesia and ICU care, added Dr Sanjay Khatri.

“But we managed to cure the baby without an open-heart surgery. It was the first-of-its-kind attempt and we are very happy that the baby survived,” said Dr Kaushal.

He added that the family, particularly the baby’s father Deepak Rewani, was very supportive.
Deepak was elated after the successful treatment.

“I had lost all hopes. After seeking medical help at several places, the baby was put in the care of Dr Kaushal. It was nothing but a miracle that my son survived. I am so thankful,” said Deepak, a resident of Jaipur.

Fortis Escorts Hospital, Jaipur is the first NABH accredited multi-super specialty hospital in Rajasthan, established on August 2, 2007 with the mission to bringing quality medical care to Rajasthan. The 250-bed hospital is spread over an area of 6.67 acre.