New Delhi: But for successful surgery in Indraprastha Apollo, 3 month old blue and frail baby Zubia Fatima would not have been alive to celebrate Eid. She came to hospital with life threatening congenital heart condition.
Zubiya Fatima was diagnosed with a rare congenital heart disease, which was found to be a mix type of TAPVC (Total Anomalous Pulmonary Venous Connection). She was also suffering from pulmonary arterial hypertension (PAH) due to high lung pressures. A resident of Lucknow, Uttar Pradesh, Zubiya was born to non-consanguineous married couple and was delivered prematurely by caesarean surgery.
Already a weak baby by birth, Zubiya had bluish colouration of skin and used to breathe rapidly since one month of age. Her parents consulted doctors in their hometown, where the infant was diagnosed with Supracardiac TAPVD (Total anomalous pulmonary venous drainage) and referred to Indraprastha Apollo Hospitals for treatment.
Dr. Muthu Jothi, Senior Consultant, Paediatric Cardio Thoracic Surgeon, Indraprastha Apollo Hospitals, New Delhi is an expert in treating young patients born with rare cardiac complications. However, Zubiya’s condition presented an exclusive congenital circumstance in which the baby was suffering from a unique type of cardiac malformation, “The baby was diagnosed with supracardiac TAPVD, a type of congenital heart disease, in which pulmonary veins drain into a common chamber behind the heart. Due to this, the blood coming from the lungs doesn’t reach the heart.
The vein ascending from this common chamber joins the right side of the heart because of which all the blood which needs to go the left side of the heart is drained to the right side of the heart. This leads to mixing of deoxygenated blood with oxygenated blood. The only way that the child can survive is if there is a small hole between the top two chambers of the heart, that is, the right atrium and left atrium. It will allow the mixed blood to go to the left side of the heart and then be pumped into the body. But because impure blood is being pumped into the body, babies with such condition tend to be very blue and have very high lung pressures.”
Dr Jothi explained that upon doing an ECHO (Echocardiogram), it was found that the pulmonary veins were actually draining at different places, “This is a highly risky situation called mixed type of TAPVD. The right upper lobe vein was draining into the superior vena cava area, the right lower lobe and left lower lobe veins were draining in the common chamber and the left upper lobe vein was draining by vertical vein into the right side of the heart. So technically it becomes very difficult because all of these pulmonary veins are draining at different places, and all of them had to be brought together and make them drain the blood into the left side of the heart.”
Dr Muthu Jothi and his team accepted the case as a high-risk procedure and with the consent of the family, operated on the baby.
Dr Jothi explained the surgical procedure, “The right upper and lower pulmonary veins were surgically connected to the left side of the heart through the common chamber with a large patch inside the heart. The left upper vein which was draining separately was disconnected from the vertical vein draining to the right side of the heart and we had re-attached to the left atrial appendage. It was a very complex surgery which took 6.5 to 7 hours. It is important to understand that these pulmonary veins are very small and if they are not plugged in properly, the flow in these blood vessels is compromised and lung pressures do not come down. This was a rare form of mixed type of TAPVD which is technically quite difficult to perform. By the grace of God, we’ve had good result because the child is now doing very well.”
He concluded, “The child was on ventilator for three – four days and then discharged from the hospital after a week of the surgery. As per her latest review, Baby Zubiya is fine now. We have advised the parents to continue the medication.”The parents of the child expressed their gratitude to Dr Muthu Jothi and the tireless efforts of his team in treating their baby girl, “There is no greater joy than seeing your child healthy once again and for us, it’s like Eid has come early this year! We are immensely thankful to the experts at Indraprastha Apollo hospitals for having saved our daughter from such a distressing condition. We have received support from the doctors and hospital staff at every step. They never gave up and never let us lose hope.”