Life Hangs by a Thread
At 16 days old, Muhammed Riban Malik is the second child of Fathimath Rukshana and Abdul Muneer M from Kasaragod,Kerala. He was born in a private hospital with a birth weight of 3.4 kilograms. Riban also has an elder sister who is 4 years old.
Riban had no problems immediately after birth. But when he was 6 days old, Fathimath noticed that Riban was breathing fast along with difficulty in taking his feed. Worried, the parents took the child to Sunrise Hospital in Kasargod. There they met Dr. Sachin Padman, a pediatrician.
Dr. Sachin detected a murmur and suspected congenital heart defect. Thus, he did an echo with live online video support from Amrita Institute of Medical Sciences, Kochi. Dr. Mahesh K, the pediatric cardiologist at Amrita Institute assisted Dr.Sachin with the echo and found that the Mitral Valve was leaking and there was an unusual mobile structure over the valve.
Dr. Mahesh asked the parents to come to Amrita Institute immediately. Dr. Sachin helped the parents to arrange an ambulance immediately and the family of three left for Kochi. Their elder daughter stayed back at home, in the care of her paternal grandparents. The distance of 320 kilometers was covered in 7 hours.
On arrival the baby was admitted at the pediatric cardiac Intensive Care Unit (ICU). Once again a detailed echo was done. It revealed a very rare and unusual finding. There was a very prominent pedunculated mass (tumor) flopping in-and-out of the mitral valve, having a long, thread-like attachment deep within the left atrial appendage. The tumor was freely moving within the heart along the axis of its attachment to the appendage, plopping in-and-out of the mitral valve like a yo-yo.
The removed mass
Usually, it is extremely rare for a tumor to arise from a location like the left atrial appendage. The tumor was held by just a thin, thread-like attachment, and was clearly at risk of breaking away and embolizing into the circulation at any moment. If that had happened, there would have been obstruction in blood flow and the baby would not have survived. Moreover, Riban also had some ventricular dysfunction.
The diagnosis and criticality of the case was explained to the parents. The baby required an open heart surgery to cure the defect.
Abdul Muneer M works in a hotel with a monthly income of Rs 5416. He managed to arrange a sum of Rs 64,271 from his friends for the surgery. Along with the discount given by Amrita Institute, Abdul Muneer still needed financial aid. With help from Genesis Foundation and Oracle India, Riban underwent a successful surgery after testing negative for the COVID-19 test.
Riban underwent open heart surgery on 13th June. The surgery was done by Dr. Brijesh P K. and lasted for 4 hours. The post-surgery period was uneventful and thus the baby was discharged in a stable condition on 23rd June. The family had a few friends in Kochi who helped them during the stay in the hospital and also arranged a vehicle for their return journey.
At 16 days old, Muhammed Riban Malik is the youngest baby in India to have a cardiac mass removed from the Left Atrial Appendage