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The smallest baby to be operated upon in India for a heart disorder

Thank God for the Small Miracles!

Seventeen years is how long Lalmati and Mohanlal had waited for a child to be born to them. Their happiness knew no bounds when Lalmati’s pregnancy was confirmed. They couldn’t wait to meet their little bundle of joy, and it seems, neither could he, for their little son, born at 28 weeks, was born 12 weeks premature, in his impatience to cuddle with his loving parents.

The premature birth itself was a terrifying ordeal for the family, with their tiny baby weighing only a kilogram, and it meant constant vigilance by doctors in the intensive care unit. He was being treated in a level III intensive care unit, under the care of vigilant neonatologists. Over the next 23 days, Shiv, as he was named by his parents, continued to lose weight despite tube feeding and the best of care afforded by the doctors. He was finally diagnosed as having a heart disorder known as patent ductus arteriosus(PDA). PDA occurs when there is an unwanted connection between the two major blood vessels of the heart; the aorta, and the pulmonary artery. Due to this connection, oxygenated blood from the aorta is shunted into the pulmonary artery, depriving the body of oxygen rich blood. Thus often these children face health problems that impede their growth, and in some cases even succumb to further complications.

Shiv’s father, Mohanlal, is an immigrant labourer from the north of India working in a small private company in Silvassa, Dadra and Nagar Haveli. He was no longer in a position to afford NICU care at the government hospital, neither could he hope to provide tertiary paediatric care whose expertise is mostly limited to private hospitals with his limited resources, for his son.

Shiv’s weight had further dropped to 900 grams, he was dependent on oxygen provided externally, and was being fed via a tube inserted into his stomach via his nostrils. None of the medicines recommended for treating PDA had worked, and the only way forward now seemed to be a surgical procedure. The need for emergency healthcare was discussed with Genesis Foundation; which works towards heart treatment for underprivileged children, and immediate financial approvals were given, after which the baby was instantaneously shifted to Jupiter Hospital in Thane.

The baby was admitted to the NICU under Dr Srinivasan L. who specialises in cardiac procedures for such small babies. He has to his credit more than 1200 successful cardiac catheter interventions. A team of neonatal specialists were put together with Dr. Paramanand Andankar heading a team of neonatologists and Dr. Dilip Chavan and Maheshrao Thorat heading the team of paediatric cardiac anaesthesia.

A procedure called PDA device closure was performed on 28th February 2018. In this procedure, the heart defect is closed using a highly specialized implant called the PDA device, which is the best process for surgery on such small children. This implant is inserted via a venous port accessed in the baby’s thighs. The entire operation was performed with only a needle inserted into the body and without having to cut open the chest. The advantage of this procedure is the faster recovery time and least invasion. Shiv was taken off ventilator within next 18 hours and feeds were introduced immediately after the procedure. He is now stable and at present recovering in the NICU and is expected to do well.

What makes this case unique is that, at 900 grams, Shiv happens to be the smallest baby in India to undergo PDA device closure. Thus today, not only is he a miracle for his parents, but also for the medical fraternity in the country. Genesis Foundation, is blessed to have been a part of his record recovery and helping this littlest of hearts find its beat in the world.

As for Shiv’s parents, this miracle that they’ve been waiting seventeen years for, they’re just glad they get to finally take him home.