The Hindu : Karnataka / Bangalore News : Two-year-old survives risky surgery

Online edition of India's National Newspaper
Sunday, Feb 26, 2006

Karnataka

Karnataka - Bangalore

Two-year-old survives risky surgery

Rasheed Kappan

RELIEVED MOTHER: Michelle with her son Josef at Manipal Hospital in Bangalore. — Photo: K. Gopinathan

BANGALORE: The parents of Josef Vasquez received some shattering news two years ago: Their five-month-old baby had a congenital heart defect — corrected transposition — a rare cardiac anomaly that occurs in one in a million live births. No hospital in the Philippines was ready to conduct the risky surgery required. The young couple resigned themselves to their fate when hospitals in their country declared the baby inoperable.

The baby's aunt alerted the family last year about a television report on a Filipino baby with a similar problem undergoing surgery at the Manipal Heart Foundation (MHF) here. The parents brought Josef to the hospital last month. The baby underwent two delicate surgeries on February 1 and 14, operations that the MHF doctors themselves termed extremely risky.

The days leading up to the surgeries were not easy for Josef's parents — Michelle and Geovani Vasquez. "The doctor told us that it was a delayed surgery, and the baby should have been operated upon before he turned five months. The risk was obviously very high. But we decided to take a chance," Michelle said.

A team of doctors led by N.S. Devanand, Consultant Cardiothoracic Surgeon, MHF, sat with the parents and explained the risk factors. "We only had a very marginal percentage of success. The final decision was left to the baby's mother," said a doctor in charge of international patients.

In corrected transposition, which Josef had, the main pumping chambers of the heart (ventricles) were interchanged along with the main arteries that emerge from the heart. In effect, a weaker chamber worked against high resistance body circulation and the stronger chamber worked against low resistance lung circulation (reverse of normal heart function).

This, explained Dr. Devanand, leads to heart failure at an early age. "A majority of these patients will also have associated heart problems such as a hole in the heart or narrowed valves, etc."

Josef also had a hole in the heart, obstruction of the aorta (aortic interruption) and a problem with his heart beat (intermittent heart block). "This made the risk of surgery very high with doubtful benefit," Dr. Devanand said.

Reviewing the angiogram, the team of doctors felt a correction might be possible, but the surgery would have to be performed in stages. Initially, the aortic interruption was corrected with banding of the pulmonary artery (to release lung pressure). A week later, the complete correction — Double Switch operation — was made uneventfully. In the next stage, a permanent pacemaker was inserted.

Josef is scheduled to fly back home on Tuesday.

Printer friendly page
Send this article to Friends by E-Mail

Karnataka

News Update

Stories in this Section