Amidst coronavirus lockdown, critical surgery performed on infant in Pune

A rare arterial switch surgery has given a fresh lease of life to a month-old who was brought to Jupiter Hospital in Pune. The patient was in critical condition when his family members brought him to the hospital.

The 28-day-old boy was diagnosed with transposition of great arteries and had to undergo a complex neonatal cardiac surgery of arterial switch. He was admitted to the hospital under Dr Abhijeet Naik.

However, it was a difficult situation as the numbers of COVID-19 patients were increasing across the country on a daily basis and there was a fear among patients of getting exposed to COVID-19 patients. But this 28-day-old boy needed an emergency surgery.

“Such a defect happens to 1 in 3,300 newborn infants. In the Western world, there is 3% mortality, while in the developing world it stands at 15%. It was a difficult decision for us to carry out the operation,” said Dr Naik, Consultant Paediatric Cardiac Surgeon, Jupiter Hospital.

“The first challenge we had to face was that the baby was beyond four weeks of age and it is difficult for the regressed left ventricle to support the systemic circulation. It involves transferring very tiny millimetre-sized coronary arteries onto the new aortic root. Secondly, we had to successfully complete the surgery without the ECMO machine and lastly, the surgical and ICU team had to take precautions of the highest order to prevent infection and in the situation of lockdown, the parents were also told to maintain social distancing from the baby.”

“To see all the associated personnel committed and working for saving a tiny baby's life in extreme conditions of risk and difficulty was a heart-warming situation," he said.

“Babies with this premature level are very small and very fragile," said Dr Shrinivas Tambe, Pediatrician, Jupiter Hospital. “At the time of admission, the baby came to us in a very blue condition, with oxygen saturation measuring between 35-40%. Normal saturation is more than 95%. The baby was feeling very breathless and this condition was a true paediatric cardiac emergency. The seven- to eight-hour surgery was successful and the baby was shifted to PICU. However, the next 72 hours were the most critical for the baby,” he further stated.

The baby boy went home after such a critical surgery on the eighth postoperative day, which was a measure of the quality of surgery and the ICU care.

"We would like to thank and specially mention the baby's parents, who trusted us with their baby's life in such a difficult situation for them.” said Dr Rahul Saraf, Consultant Paediatric Cardiologist, Jupiter Hospital.

The child’s father said, “It was an immensely distressing experience, having to witness our newborn child go through so much trauma. The happiness of his birth was overshadowed by his ailment. We are grateful to the doctors, due to the tireless efforts of which we have our son back with us."