When Harsh (name changed) was born he looked like a perfectly healthy child, but soon started breathing very fast and his Paediatrician heard a ‘heart murmur’. The cardiac echo showed an extremely complex heart condition which is ‘Hypoplastic Left Heart Syndrome’. It is a complex and rare congenital heart defect in which the left side of the heart of a baby is underdeveloped.
Usually, the right side of the heart pumps blood from the heart to the lungs, and the left side of the heart pumps oxygen-rich blood to the rest of the body. With HLHS (Hypoplastic Left Heart Syndrome), the baby’s heart cannot pump the oxygen-rich blood to the body.
Babies born with HLHS seem normal because an artery – the Patent Ductus Arteriosus (PDA) is open and supplies blood to their body. Everyone has this artery (PDA), which remains open until the time they are in their mother’s womb. Once the baby is born and starts breathing, the artery (PDA) gets closed probably within hours or a few days.
Babies with no heart condition do not face any problem once the PDA is closed (in fact it is required); however, its closure in babies with HLHS can cause instant death.
Harsh was born in the remote area of Himachal Pradesh. Three days after birth, an echo had confirmed his heart condition due to which his survival was at risk. An immediate Norwood Operation (open – heart surgery) was required to save his life.
Norwood Operation is performed only in the handful of hospitals in India and Artemis Hospital in Gurugram is one of them. Knowing this, the Paediatric Cardiologist of the child Dr. Dinesh Bisht contacted Artemis Hospital.
Post knowing the critical situation, Artemis Hospital was all geared up to save the life of the little one. Amid the nationwide lockdown, the biggest challenge was to bring him to the hospital quickly which was magically done by the ambulance driver who drove 320 km in 3 hours.
Dr. Aseem Ranjan Shrivastava – Head Paediatric Cardiac Surgery, Artemis Hospital says, “When we received the baby, he was struggling to survive, the PDA had almost closed, and Kidney failure had set in. A medicine to open this artery was started, and the child stabilized over the next few days in the Paediatric Cardiac ICU. Once his condition was stable, 10 hours long surgery – Norwood operation was performed on him.“
During this challenging surgery, the aorta (the main artery from the heart to the body) was rebuilt, and the blood supply to the body became possible through this new aorta. The blood vessel leaving the right side of the heart (pulmonary artery) is divided. The pulmonary artery and its pulmonary valve are connected to the small aorta and the small aortic valve. A patch was then sewn in this area to make a new and bigger aorta. Now all the blood leaving the heart goes through the pulmonary valve and out to the body through the new aorta.
A tube-shaped graft was then used to connect the pulmonary artery to the right ventricle – this is called a Sano Shunt. This shunt provides blood supply to the lungs (earlier blood to the lungs was supplied by a pulmonary artery which has already been used up to re-create the Aorta).
“We are grateful to the ambulance driver and Dr. Aseem along with the entire management team of Artemis Hospital. They did not let us lose hope and saved the life of our child” said the father of the child.
The operation went successful, and the baby responded to it well. Presently he is in the ICU and making a strong recovery.