HYDERABAD: A three-day-old neonate, who had an extremely rare combination of two major lesions in the heart was successfully operated on at KIMS Hospital.
The baby had Transposition of Great Arteries (TGA) in which the two primary tubes (aorta and pulmonary artery) that carry blood from the heart to the body and lungs are switched. This causes the body to receive impure blood, leading to cyanosis and a blue appearance, as the blood is not oxygenated in the lungs and the heart’s chambers do not mix.
Furthermore, the presence of another condition Total Anomalous Pulmonary Venous Connection (TAPVC) complicated the situation. It caused a reversal of the pulmonary veins that carry blood from the lungs to the heart. Essentially, the blood from the lungs was flowing into the right atrium instead of the left atrium as it normally would.
After being stabilised on a ventilator to improve heart function, a surgical procedure was performed on the baby known as an arterial switch operation to correct the lesions caused by TGA. However, this procedure presents a significant surgical challenge that requires the transfer of the coronary arteries along with the aorta, which can be delicate and fragile in a three-day-old neonate. Even a small kink or misstep in this process can result in severe damage to the ventricle and could be fatal for the baby. TAPVC required the pulmonary veins to be re-routed to the left atrium.