A mother had lost her 12-year old child in an accident and it was after many years that a ray of happiness broke through the shadows of sorrow when she became pregnant again at the age of 50 years. Baby Ganesh was born preterm with a low birthweight of just 900 grams and a congenital heart defect threatened the happiness of the parents, but timely advanced cardiac care just 20 hours after birth and a complex open heart surgery when the baby was 67 days old by the specialist team of doctors at Kokilaben Dhirubhai Ambani Hospital (Kokilaben Hospital) gave the baby a second lease of life and brought smiles back to the parents’ faces.

The mother was referred to Kokilaben Hospital in the first trimester of her pregnancy as there was suspicion of the foetus having cardiac issues. Foetal echocardiography revealed that the developing foetus has Transposition of the Great Arteries (TGA), a type of cyanotic heart defect in which the two main arteries carrying blood out of the heart  to the lungs and body, the main pulmonary artery and the aorta, are not connected correctly and are switched in position or transposed.

Dr Suresh Rao, Director, Children’s Heart Centre and Consultant, Paediatric & Congenital Heart Surgeon, Kokilaben Dhirubhai Ambani Hospital said, “The result of complex congenital heart diseases can be severe if undiagnosed before birth. However, the outcome with TGA is improved with prenatal detection of the condition. In this case, the couple had already lost their earlier child in an accident and given that they were an elderly couple aged 50-plus, this baby was their only chance to have a child. The mother and foetus’ condition was monitored throughout the pregnancy. Due to complications that the mother had in the 29th week, we have to deliver the baby preterm. The baby was immediately put on ventilators as his lungs were not developed.”

The preterm baby weighed just 900 gm at birth. The doctors planned for corrective surgery and decided to wait till the baby gained some weight. However, just 20 hours after birth, the baby’s condition deteriorated rapidly with a critical drop in oxygen levels. An emergency procedure called Balloon Septostomy, a minimally invasive cardiac procedure to temporarily manage the defect was performed.

Dr Prashant Bobhate, Consultant, Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital said, “Cardiac surgery in infants with low birth weight is associated with high risks. Hence, considering that the oxygen saturation had dropped to 35 percent, we decided to do a temporary minimally invasive procedure called Balloon Septostomy to enhance blood oxygenation and give the newborn some time to stabilise and become fit for the major corrective surgery.”

The infant was admitted to the Neonatal Intensive Care Unit (NICU) at Kokilaben Hospital for constant monitoring under the guidance of Dr Tanuja Karande, Consultant, Pediatric Cardiologist and Dr. Preetha Joshi, Consultant, Neonatal, Pediatric and Cardiac Intensivist. Due to premature birth, the baby had very poor immunity, which despite the best efforts led to several infections over the next few weeks.

Dr. Suresh Rao said, “The baby at just over two months of age became critically ill requiring immediate surgery. Despite the baby now being just 1.5 kg., we had to proceed to save the baby’s life. We performed an Arterial switch surgery on the child which was extremely difficult and complex due to the low weight.  This child’s low weight and age was a huge challenge and its premature infections only added to the complexity. Such surgeries are usually done when the babies weigh at least 2 kg. The child remained under observation in the NICU at Kokilaben Hospital for 86 days and was then discharged after an uneventful recovery. We are glad that despite all challenges, the surgery was successful and we were able to give the baby a second chance at life. This was made possible only because of the availability of various specialist doctors under one roof rendering full time support and emergency care.”

The baby’s mother conveyed her gratitude, “The team of doctors at Kokilaben Hospital left no stone unturned to save our precious child. This was a testing time for us and we are grateful to the doctors and the entire team at Kokilaben Hospital for their constant care and support. Right from diagnosing the complication to treating it, they ensured my baby is well protected at all times. It was only because of their being available 24*7 to look after my baby that my husband and I are getting a chance to experience parenthood once again!”