The Hindu : Child with hole in heart undergoes surgery successfully

Online edition of India's National Newspaper
Sunday, Oct 26, 2003

Southern States

Southern States - Tamil Nadu

Child with hole in heart undergoes surgery successfully

By T. Saravanan

Two-year-old Sneha who underwent a complex heart surgery.

MADURAI OCT .25. A complex heart surgery was successfully performed on a two-year-old girl of Vannankundu in Ramanathapuram district at the Meenakshi Heart Institute here recently.

B. Sneha was referred to the hospital after having been diagnosed for a common heart ailment, atrial septal defect, a hole between the upper two chambers.

The doctors found that the child was surviving because of the hole and the closure of the ASD will prove fatal. She was diagnosed to have been suffering from total anomalous pulmonary venous connexion, an MHI release said.

In normal conditions, blood comes to the right side of the heart and goes to the lungs for purification. The pure blood goes to the left side and then to the whole body.

In a patient suffering from the TAPVC , pulmonary veins, which bring pure blood to the left side, are anomalously connected to the right side. The only way blood can reach the left side is through the hole between the two chambers. Such an anomaly occurs in 1.5 per cent of cases.

Detecting the deformity after an echocardiogram, doctors conducted a cardiac catheterisation, a test involving insertion of a fine plastic tube into various chambers, injecting a radio opaque dye and taking X-rays. The test not only confirmed the diagnosis, but also revealed that the child had multiple wrong connections. Only part of the lung was connected to the right side of the heart directly. Part of the heart was indirectly connected through other veins. In medical terms it is called `mixed type TAPVC'.

The operation involved putting the child on a heart-lung machine and reducing the temperature to 15 degree centigrade (normal temperature being 37 degree centigrade), so that the blood flow can be stopped during the critical period of the operation.

Blood flow was directed from the lungs to the left side of the heart. The hole between the two atria was closed, using a tissue taken from the child itself.

Sneha was on respiratory support for four days. A team led by A.R.Raghuram, performed the operation free of cost.

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