2-year-old Pratik is the youngest child of Priyanka and Krantikumar from Bidar in Karnataka. They have an elder son who is 7 years old. The parents were thrilled at the arrival of a new baby in their life, but their joy was short lived. A month after his birth, his parents noticed that Pratik started having problems with breathing along with a bluish discoloration of the body. Worried, the parents took their child to a nearby hospital. Seeing the symptoms the doctor suspected a Congenital Heart Defect. An Echo was done but the doctor was still not sure of the diagnosis. Therefore, the doctor referred Pratik’s parents to Krishna Institute of Medical Sciences (KIMS), Hyderabad for consulting a pediatric cardiologist.
Krantikumar and Priyanka immediately left for Hyderabad in an ambulance. Krantikumar works in a jewellery shop with a monthly income of Rs 7500 per month. He borrowed a sum of Rs 1 lakh from his employer, as he anticipated a lot of expenditure. Once they arrived at the hospital, an Echo was conducted. Pratik was diagnosed with a complex congenital heart defect - transposition of Great Arteries with VSD and Pulmonary Stenosis. In this condition the two main blood vessels of the body i.e. the Aorta and Pulmonary Artery arise from the wrong chambers of the heart. The Aorta arises from the right chamber and the Pulmonary Artery arises from the left chamber of the heart. Moreover, there was hole in between the lower chambers of the heart (VSD). What made the defect complex was the Pulmonary Valve was very narrow, restricting the flow of blood to the lungs. Hence the oxygen saturation level of the body was low. The only way to cure Pratik’s heart defect was an open heart surgery.
Considering Pratik’s young age, the doctors decided to do a palliative procedure called PDA Stenting. In this procedure a stent is placed inside the PDA (the tube between the Aorta and Pulmonary Artery). By placing a stent, the PDA is kept open, resulting in more flow of the blood to the lungs thereby increasing oxygen saturation level in the body. Post discharge the parents were in continuous follow up.
In March 2020, just before the COVID-19 lockdown, his parents took Pratik for a check up. Doctors observed that Pratik had started having breathing problems again. Once again, an Echo was conducted. Priyanka and Krantikumar were told that Pratik had to be operated upon, within the next three months. They were told that the surgery would cost around Rs 350,000. Krantikumar wanted some time to arrange money for the surgery. He had already borrowed Rs 100,000 for the first procedure.
The parents came back to Bidar and reached out to their friends and relatives. They collected Rs 150,000. Since the parents could not arrange the entire cost of surgery, the hospital reached out to us for support. And with aid from WPP India CSR Foundation, the surgery was planned for June. It is also the first case of Pulmonary Root Translocation supported by us. Since there was no public transport available due to the COVID-19 pandemic, Krantikumar’s employer arranged a vehicle for the family to travel to Hyderabad. Their elder son stayed back at home, being looked after by his paternal grandparents.
On arrival Pratik was admitted after a negative COVID-19 test. Dr. Anil Kumar Dharmapuram, pediatric cardiac surgeon at KIMS Hospital, decided to do a rare kind of surgery called the Pulmonary Root Translocation. In this surgery, the Pulmonary Valve with the Root and the Pulmonary Artery are extracted from the left ventricle and implanted to the new location, i.e. the right ventricle. This way the Pulmonary Valve is repaired. Simultaneously the VSD (hole in between the lower chambers of the heart) is closed with a patch in such a way that pure blood from the left ventricle flows into the Aorta through the VSD patch, thus completing the repair. The main challenge in this surgery is the removal of the Pulmonary Root from the left ventricle, because of its close proximity to the Aortic and Mitral Valve.
At 2 years of age, Pratik is the second youngest child in India to undergo Pulmonary Root Translocation.
The postoperative period was uneventful. Pratik was weaned off the ventilator on the 4th postoperative day. His progress was good and he was discharged in a stable condition. Pratik was admitted for 18 days in the hospital. The hospital provided free accommodation and food to the parents during their course of stay. Krantikumar’s employer helped to arrange a vehicle for their return journey.