Breakthrough Interventional Procedure at KLE Belagavi Saves 40 days old Infant with Rare Heart Condition

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BM BUREAU: The 40-day-old infant underwent a life-saving interventional procedure at KLE Hospitals in Belgaum for Tetralogy of Fallot with pulmonary atresia, a complex congenital heart defect. This procedure, performed in the catheterization lab on a beating heart, was the first of its kind in North Karnataka. Surgery was initially ruled out due to the condition’s complexity, leading to the decision for an interventional procedure.

In Photo: Dr Danish Memon

The infant, referred from a hospital in Goa, was ineligible for surgery elsewhere due to the condition’s high complexity. After evaluation, a PDA stenting procedure was chosen over a BT shunt surgery. The goal was to stent the vessel connecting the two large arteries to provide blood for lung oxygenation. This posed challenges as only the left lung was connected to the vessel, while the right lung’s vessel was underdeveloped. The procedure was further complicated by the infant’s unstable condition and low blood oxygen content at admission.

The procedure, involving the use of a stent designed for adult coronary angioplasty due to the unavailability of suitable hardware for infants, required a multidisciplinary team led by Dr. Danish Memon, including neonatologist Dr. Manisha Bhandankar, pediatric cardiologist Dr. Danish Memon, chief cardiologist Dr. Suresh Patted, pediatric cardiac anesthetist Dr. Manjunath, and cath lab technical staff led by Mr. Rajesh T.

The infant was stabilized in the Neonatology unit before undergoing the procedure, which involved passing a catheter through the femoral artery in the groin to position a stent at the vessel site and improve blood oxygen content. Post-procedure, the infant experienced a challenging adjustment to the new circulation, requiring further management in the neonatal unit. However, the hemodynamics gradually improved, and the infant was discharged a week after the procedure.

Follow-up cardiac evaluations have shown promising results, with the infant gaining weight, showing improved activity, and maintaining stable oxygen saturations. Such interventional procedures are seen as lifesaving, cost-effective, and associated with lower risks and faster hospital discharges compared to surgical procedures. It is anticipated that these procedures will become more common in the future.

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