Fortis Hospitals, Mulund (formerly Wockhardt Hospitals) marks a feat in the field of paediatric cardio-thoracic surgery by performing a complex beating heart coronary artery bypass surgery on an infant. A team of cardiac experts led by Dr Suresh Joshi, consultant paediatric cardiac surgeon, Fortis Hospitals has successfully corrected a complicated and rare congenital deformity called ALCAPA (Anomalous Left Coronary Artery From the Pulmonary Artery) giving the baby a new lease of life.
Baby Sharon was born with normal delivery without any specific symptoms of heart defect during her birth. However, after 4 months she suffered from severe cold and cough and was admitted in a city hospital as she was diagnosed of pneumonia. The baby seemed to suffer from increased breathlessness with a very high heart rate. On further investigation the baby was diagnosed of having an enlarged heart and the parents were advised to consult a paediatric cardiac surgeon.
“The baby was brought to us in a severe condition where she was suffering from severe breathlessness, excessive crying and was extremely feeble due to poor intake of feed. Upon further investigation we diagnosed her with a congenital heart defect called ALCAPA .The ALCAPA is a rare birth malformation where the positions of the arteries are switched and the left coronary artery comes out of the pulmonary artery. It occurs approximately in 1 in 4-5 lakh live births (0.25% - 0.5% of the total birth defects) and if not treated at the appropriate time accounts for 65% - 85% of deaths within 1st year of life from congestive cardiac failure,” says Dr. Suresh Joshi.
At the time of birth babies born with such deformities remain active like any normal child but as the child grow the symptoms manifests into breathlessness, inactivity and weak intake of food and they grow very weak and uncontrollable.
“ALCAPA is a serious problem and requires surgery immediately after the birth or as soon as the diagnosis is confirmed. The aim of surgery is to connect the Anomalous left coronary artery with the aorta. The precise surgery depends on the exact location of the Anomalous left coronary artery. Sometimes, it can be moved, along with a button of tissue, from the pulmonary artery and sewn into the aorta. If the Anomalous left coronary artery is located too far away from the aorta to move, a "tunnel" is made from the aorta to the Anomalous left coronary artery or by pass surgery is done by using artery of left arm.”
“Usually to perform such complex surgery heart lung machine is required which is also commonly called on-pump bypass surgery. However, in the case of this baby, we performed the surgery successfully without using heart lung machine, which means, off pump Coronary Artery Bypass Graft (CABG) procedure with the self equipped instruments. Off pump bypass surgery are much common in the adult procedure group, but in neonates such procedure till date is only heard off” added Dr Suresh Joshi.