Wockhardt Hospitals' paediatric cardiac team has successfully carried out a Congenitally Corrected Transposition of Great Arteries (CCTGA) on a 11-month-old infant from Orissa. This condition is reported in less than one per cent of the children born with heart defects. The paediatric cardiac team led by Dr Devananda, consultant Cardiac Surgeon, Wockhardt Hospitals performed the surgery in six hours.
The infant was observed to have breathing difficulty in her second month and upon consultation with the local doctors in Orissa they were referred to Bangalore for further consultation and treatment. The diagnosis revealed congenital ventricular septral defect and straddling tricuspid valve. In this case the pumping chambers (ventricles) are switched along with the great arteries (aorta and pulmonary artery). The baby also had a large hole in between the ventricles and encroaching of one of the valves across the hole. Children born with this kind of defect are reported to have abnormal electrical conduction system and are highly susceptible to a complete heart block.
According to Dr Devananda, this is one of the rarest cases observed in congenital heart defects where the chambers along with the arteries were in the reversed position. Since it was a complex case we had to perform three cardiac procedures on the baby in one sitting.
To begin with closure of the VSD (ventricular septal defect) was done in such a way that the encroachment of the valve did not hamper the blood flow. Surgeons redirected the pure and impure blood to the respective normal ventricles (atrial switch or senning operation) and switched the great arteries to the respective ventricles (arterial switch).
For a 11-month-old infant anaesthesia is a challenging role and in this case considering the cardiac anomaly and criticality of the procedure, it was complex. "We had to ensure that the baby's vital organs were protected throughout the surgery and no complications occurred," informed Dr Ramesh Reddy, consultant Cardiac Anaesthetist, Wockhardt Hospitals.
The post operative course of the infant was smooth and she was on breathing support machine for five days. The feeds were commenced on day seven post surgery and the baby was in the ICU under observation for 10 days. "The infant did have conduction problem and the recovery was smooth. Further follow ups after two weeks showed positive results and the baby was doing well, gaining weight and her cardiac examination was normal," said Dr Prakash Vemgal, consultant Neonatologist & Paediatric Intensivist, Wockhardt Hospitals.
The baby can lead a normal life and will not require any further surgical treatment. The treatment was done at a subsidized cost at the hospital and was supported by the Needy Heart Foundation.