Wockhardt Hospitals, now a network hospital of Fortis, has successfully set right a complex heart deformity on a two-year old infant from Nigeria without any blood transfusion.

A team of cardiac experts led by Dr N S Devananda, consultant cardiac surgeon, Wockhardt Hospitals has performed the major open heart surgery. The baby Brendan was suffering from congenital heart defect referred to as Tetralogy of Fallot or complex blue baby syndrome.

“In this syndrome the pure and impure blood gets mixed in the heart and the blood flow to the lungs is decreased. It is the most common complex heart defect, manifested in 55-70 of the cases. It can prove fatal if it is not treated in time,” said Dr Devananda.

A challenge for the cardiac team was that the baby’s parents belonged to the Jehovah Witness community and as per their religious belief, transfusion of blood or use of any blood is unacceptable.

To handle the blue baby syndrome, surgeons have two treatment options. One is palliative care where no open heart surgery is done and the defect is treated with ‘shunt’ operation. The second is complete repair which is a definitive treatment. Here the patient undergoes an open heart surgery with a heart lung machine. In the case of the infant patient, the cardiac team chose the second option because of its curative value. “But the heart lung machine required 500 ml of blood to drive away the air and ‘still’ haemoglobin at acceptable level. The baby weighed only 11 kilograms with a blood volume of around 900 ml. To conduct an open heart proved difficult without additional usage of blood,” he said.

The team modified the heart lung machine circuit in such a way that the total priming volume was reduced to the least possible. The haemo-filteration technique was used to draw out the excess water from the body before the baby underwent the open heart surgery and was out of ICU within 24 hours. A week after the surgery, cardiac team reported that the infant could now lead an active life like any other child of his age and all post operative tests are normal.