Tiny Preemie Girl weighing 800 grams saved by extremely difficult rare key-hole cardiac procedure at Sri Ramakrishna Hospital

Coimbatore: A lady from Erode delivered twin girls at just 6 ½ months of pregnancy in the month of March. The first baby who weighed just over 800 grams was diagnosed with a heart defect called “Critical Pulmonary Stenosis” where the valve sending blood to lungs was almost closed. 

After losing the second baby, the desperate parents, with an aim of  saving this baby, approached Sri Ramakrishna Hospital, Coimbatore. As per parents' request, the NICU team of Sri Ramakrishna Hospital transferred the baby from Erode to Coimbatore in a dedicated Neonatal Transport Ambulance which possesses a mini Neonatal Intensive Care Unit with incubator, ventilator, etc.

"Sri Ramakrishna Hospital is the first hospital in the western Tamil Nadu to have the state-of-the-art facility ambulance with mini NICU which is available to transport critically ill premature babies" , said Dean, Sri Ramakrishna Hospital. The baby was admitted to Sri Ramakrishna Hospital under the care of Dr.Siddhartha Buddhavarapu, Dr Suja Mariam and the NICU Nursing Team. After a long wait and a lot of complications like pneumonia, sepsis, hypoglycaemia, low platelets, many blood transfusions and long days of ventilation the baby’s general condition improved but the heart problem worsened.

"The valve block became severe and heart failure worsened and her blood oxygen levels became low. Therefore, the doctors decided that the critical heart problem should be treated immediately. Usually, the opening of the valve should be 5 millimetres but here it was just the size of a pinhead (1 mm)", said Dr.S Devaprasath, her Paediatric Cardiologist. A team of doctors headed by Dr S Devaprasath, Paediatric Cardiologist,    Anaesthetist Dr. Menon, Dr Manikandan, and Dr Muthurajan, Interventional Radiologist performed a rare and intensive key-hole procedure, Balloon Pulmonary Valvotomy in Cardiac Cath Lab when the baby was just 2 months old.

The most difficult procedure was a risky one because of her tiny size. A catheter with an attached balloon was inserted through her neck veins and up to her heart, where the balloon was inflated to widen the opening, without an open-heart surgery. The procedure was a success and now the baby has only a mild narrowing of the valve. We had to wait till her infection was controlled and the lung condition improved. The procedure went smoothly as we were well prepared. The success of this procedure has now widened the scope for the same in such small babies with critical valve diseases who are usually labelled as 'cannot be saved' " said Dr. S Devaprasath, the Head of Paediatric Cardiology Department.

“The baby was extremely small and she had complications of weight and prematurity. Challenges were many and continuous. On day one transporting her on a ventilator was a challenge. After that when she developed pneumonia and sepsis, we almost lost hope, but the baby was a fighter. With the effort of all our nurses and doctors, we were able to make her fit for the procedure. She is now healthy and neurologically normal. We are incredibly happy that we were able to save her life and send her home happily with her parents” said Dr.Siddhartha Buddhavarapu and Dr Suja Mariam.

"It is very rarely done in such small babies, especially with this low weight. Only a few case reports of this kind are found internationally. Based on the medical literature, the weight of the babies undergoing such procedure was 1.2 to 1.5 kg.  The baby who underwent the procedure in our hospital is the rarest one who has successfully undergone the procedure with such a low weight. This week, our mighty tiny baby reached 1.42kg, with her fighting spirit and now she is ready to be discharged", said Dr S Devaprasath.