Two-day-old baby undergoes operation for heart condition, 'rare' in newborns

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New Delhi, Jul 5 (PTI) A two-day-old baby who suffered from a narrow heart valve condition successfully underwent operation at a leading facility here using balloon dilation technique by a minimally invasive procedure, hospital authorities said on Monday.

The newborn boy had aortic stenosis (narrow heart valve), a congenital heart condition. While the procedure has been performed on infants before, the condition is 'rare in newborns' since it is mainly age-related, making this 'one of the first cases in India' done on a two-day-old child, the hospital claimed.

In a procedure requiring maximum precision, a team of cardiologists at BLK–Max Super Speciality Hospital saved the life of the boy by successfully treating him for a congenital heart condition called valvular aortic stenosis, the hospital said in a statement. Aortic stenosis is a term used to describe congenital heart defects that obstruct blood flow from the heart to the body. Significant aortic stenosis is relatively uncommon, affecting about six of every 1,000 babies born, occurring more often in boys, it said.

The doctors used balloon valvuloplasty of the valve (BAV) in cardiac cath lab by angiography, ensuring minimum invasion, it added.

If the treatment was not given on priority, the baby's left heart could have failed completely. The doctors opted for the minimally invasive angiographic method over surgical valvotomy as they were sure of excellent results requiring less hospital stay with lower morbidity and mortality, a spokesperson of the hospital said.

Subhash Chandra, Chairman and HOD-Cardiology, BLK-Max Super Speciality Hospital said, “The neonate was referred to us with the diagnosis of mild aortic valve stenosis in 'shock' (poor respiratory effort with poor perfusion of the body with decreased urine output). He was gasping for breath with poor perfusion of the body'.

On examination, it was found that his breathing was fast with signs of shock and decreased urine output. The echocardiogram showed deformed aortic valve with critical narrowing of the valve and very poor heart pumping. At once, we counselled the distressed family about the procedure and went ahead with it immediately, he said.

The operation was done on June 17, the spokesperson said.

Elaborating on the procedure, Gaurav Agrawal, senior consultant, interventional paediatric cardiology, at the hospital said, “The newborn was put on a ventilator support through intubation and taken to the cath lab with the plan of ballooning of the critically constricted valve. After securing the desired vessel in his thigh, we faced extreme difficulty in crossing the valve but after several attempts, we managed to do so'.

Another big challenge was with the selected balloon not crossing the valve since the valve was extremely narrow.

'We had to try out different sizes of balloons so we could finally achieve the desired results,' he added.

In balloon dilation, cardiac catheteridation is done by inserting a tube, also known as a catheter into a blood vessel in the groin, which is then guided towards the heart of the patient. The catheter contains a deflated balloon on its tip. Once it is placed in the narrow valve of the heart, the balloon is inflated to stretch the valve open, doctors said.

Despite the procedure, there were still some issues that were impeding healthy recovery, Chandra added.

'Post the procedure, the baby was shifted to NICU for monitoring, however, there was still no pulse in his left leg. We decided to continue the patient on medicines and fortunately after around three hours, his pulse returned. We extubated the baby the next day as he was showing stable vitals. He was discharged the very next day with a well-opened narrow valve and near normal pumping of the heart,' he said.

Valvular aortic stenosis is an extremely rare condition in paediatric heart and neonates with shock, doctors said.

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