Name: Mast. P.Goutham
Consultant: Dr. Suman Vyas
1. Why STAR?
Ans: Already before, we came to this hospital.
2. Was STAR upto your expectations?
Ans: Very good.
3. Likes – specific areas of recommendations?
Ans: Aarogyasri ward.
Diagnosed with Atrial Septal Defect
Lakshmi mother of 3 year old Navyssri was getting concerned to see that her daughter wasn’t gaining adequate weight despite a good appetite, and also seemed to be prone to recurrent respiratory infections. To see her little daughter falling ill frequently was an ordeal for the mother. Navyasri was less active & also played less as compared to other children of her age. Worried, Lakshmi and her husband Prasad decided to get their baby examined, after a couple of visits to doctors and after a few tests the couple were shocked to learn that their daughter had a large hole in her heart, an Atrial Septal Defect. This is a birth defect and was missed in earlier diagnosis. The doctor consulting the couple referred them to the specialists of STAR Hospitals, who have years of experience in handling congenital heart defects and offering advanced pediatric cardiac care services.
The worried parents were informed by the doctors at STAR that Navyasri’s hole would need to be closed immediately to prevent further deterioration, they were also informed that there was a high risk of pulmonary hypertension (damage to the lungs), if the defect was left untreated. The doctors assured the parents that their baby would be fine.
There were 2 options – 1. Surgery, which would mean as open heart surgery with the child being put on a heart-lung machine – a process that would take about 3-4 hours and would leave her with a permanent scar, and 2. Percutaneous closure, where the doctors would put a small tube (sheath) in the blood nasals of her thigh and pass a device through this tube till her heart and position it in the right place under fluoroscopic (X-Ray) monitoring. Though the choice of going ahead with Percutaneous closure that was a minimal invasive procedure seemed simple and obvious to the the parents, it really wasn’t so simple in Navyasri ‘s condition.
It involved high risk as she was very small, weighing only 9kg and the device closure can sometimes be difficult in children less than 15kg. But the other option of Surgery would mean a lifelong scar that the baby would have to grow with. Navyasri’s parents didn’t wanted their baby to have a permanent scar.
The experts at STAR went ahead with the challenge that percutaneous closure procedure posed, the baby was initiated on medications 2 days prior to the procedure and then underwent the device closure successfully under fluoroscopic and TEE ( Trans- Esophageal Echo Cardiology) guidance. Placing a 16mm device in a small child was tricky but the expert team of doctors at Star were able to carry it out successfully. The doctors strong competence and extensive experience helped in successfully completing the high risk hole closure with the baby’s safety as their top priority. The baby was discharged after 2 days and is now back at home. She is already feeling better, plays better and has a markedly improved appetite – all this and with no scar left behind to remind Navyasri about the operation she underwent.
“It was a very scary time for me and my husband but the doctors at STAR assured us that our daughter was in good hands and this was just the beginning of a great thing in our life. I remember how calming their words were to us and we were confident we were in the best hands. I thank Dr. Nitin and his team for the outstanding care given to our daughter. Its wonderful to see her grow like other normal kids now.”
– Lakshmi (Mother)
The joy of Rajitha and Ellaiah, who married just over a year back, had no bounds when Jaswanth their first child was born, but soon the joy turned into a nightmare for the couple. They noticed that all was not well with their son, Jaswanth who weighed only 2.5kg was not feeding well and was breathless after feeds. This left them in jitters and the parents rushed their son to a local hospital, the doctors examined the baby and referred them to STAR Hospitals.
The shocked parents brought 15 days old Jaswanth to STAR. The baby was evaluated at and was found to have severe complications of the heart – Bicuspid Aortic valve, severe aortic stenosis with severe Left Ventricular (LV) dysfunction. The options were surgery or percutaneous procedure (Balloon valvotomy) but both unfortunately were very risky in Jaswanth’s case in view of his age and weight – he was only 15 days old and weighing barely 2.5 kgs to sustain the operation, plus he also had complication of severe LV Dysfunction. He underwent a PBAV (percutaneous balloon aortic valvuloplasty) – it was very difficult since the arteries in newborns are very small, and moreover all neonatal interventions are always risky. Arterial access in small newborn children can be very difficult and time consuming especially when arterial pulsations are not palpable, as in Jaswanth’s case.
The doctors managed to gain aterial access, after gaining arterial access in the right femoral artery (artery in the groin) a small catheter was introduced till Jaswanth’s heart and pressure gradient across the aortic valve was measured. Subsequently a 6mm x 20mm balloon was positioned across the valve and inflated, following which the pressure gradient decreased dramatically. The blockage was relieved. Inspite of the many problems in Jaswanth’s condition, the expert team of Pediatric cardiologists at STAR completed the complex operation successfully.
The baby was kept in the ICU for 2 days and then shifted to patient room. Subsequent echoes showed improvement in LV function and he was discharged home. Today, Jaswanth is a very active child and is doing very well.
“Our life’s best moment turned into a nightmare but Thanks to STAR, they made our fight against our son’s ailment seem much easy. I am deeply indebted to the doctors of STAR Hospitals, they are not only extraordinarily talented but also very compassionate and supportive.”
– Prasad (Father)
Baby of Wasia Alim
Baby of Wasia Alim was born out of normal delivery. On the 8th day of life the baby developed sudden respiratory distress and looked pale and lifeless. She was immediately taken to a neonatal Pediatric hospital in the emergency and was resuscitated. The baby was diagnosed do have a cardiogenic shock. Cardiogenic shock is a state in which a weakened heart isn’t able to pump enough blood to meet the body’s needs. It is a medical emergency and is fatal if not treated right away. She was intubated and put on a ventilator (breathing machine) and started on isotrapes (drugs to improve the heart function).
Cardiological and 2D echo evaluation showed a complex congenital heart defect called Coarctation of aorta in the baby that results in severe narrowing of the major vessel (aorta) that comes out of the left side of the heart and carries blood to the body. When someone has coarctation of the aorta, the aorta is narrowed at some point. This causes high pressure load on the heart and increases pressure in pulmonary artery (pulmonary hypertension), the doctors realized that it was necessary to start an important injection called prostaglandin to maintain the blood supply to the body. This drug helps by opening up a closing vessel called Patent Ductus Arteriosus (PDA) that connects the pulmonary artery to aorta.
After the baby stabilized, The doctors in this hospitals referred the parents of the baby to STAR Hospital for advanced surgery, which was immediately required to save the life of the baby. The baby was rushed to our hospital on ventilator is an incubator with fully supported transport team.
The baby underwent urgent complex surgery for the coarctation of aorta from the left side of the chest. The narrow portion of the aorta (called coarctation) was removed and the aorta repaired by tissue to tissue reconstruction. Following this the baby was managed un post operative critical care. The baby made a gradual and uneventful recovery. She was extubated (off the ventilator) on the next day. She was oral fed the following day. She was transferred back to the same hospital from where she was brought and is now doing well.
We were shattered to learned that our baby had a life threatening heart condition with little chances of survival, but when we came to STAR hospitals we were reassured. I pray that all children who are battling with complex heart problems should get access to best care, like the one we got at STAR Hospitals.”
– Abdul Alim Hyder (Father)