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Doctors at Fortis Gurgaon came across a highly complex and rare case of Master Mohd Aasim from Kashmir, who was suffering from a rare condition - the child had a large hole in the heart and his aorta and pulmonary artery were coming out of the wrong chamber. To add on to his complications, one of the main blood vessels was blocked below the valve as a result the kid had turned blue with oxygen concentration of mere 52% instead of 100%.A team of doctors, led by Dr. Vijay Agarwal, Director & HOD, Pediatric Surgery, Fortis Memorial Research Institute, successfully diagnosed and operated the patient's condition by carrying out Double Root Translocation (DRT) surgery.
Mohd Aasim, had been leading a tough life since his birth. The child was born blue and had become increasingly blue (cyanosis) with easy fatigability and tiredness. His haemoglobin increased to an alarming 20 in response to hypoxia (deficiency of oxygen reaching the tissues). At the time of admission, an echo and CT evaluation was conducted, post which a decision was taken in favour of the complicated surgery, after consultation with his family who were briefed about the risks involved. DRT REPAIR demands a series of complicated steps of planning and execution of cutting, stitching, dissecting and fashioning structures like the valves heart muscle and the coronary artery. Each step is fraught with immediate risks to life apart other general complications like bleeding infection and heart failure etc. This therefore prolongs the operation as each step needs to be given enough attention and time.
Dr. Vijay Agarwal said, "The 8-hour long operation and post-op recovery of the patient was smooth. He came out of the ventilator only 5 hours after being shifted from the ICU. The next day, his oxygen concentration was restored to 100%. He was put on a liquid and semi-solid diet and awaits discharge just 7 days after the operation. Statistics of DRT repair are not available in India but it is reckoned that only 5-6 such operations have been conducted in India by 1-2 surgeons."
Dr.Simmardeep Gill, Zonal Director, Fortis Memorial Research Institute said, "Though risky, the DRT repair yields good long-term outcomes if successful. In comparison, the other surgical options that are available are simpler but have suboptimal outcomes. One of the advantages of the DRT repair is that it does not use imported or artificial valves or conduits that run the risk of failing in the future and requiring size correction via another surgery, as the child grows older."
Transposition of great arteries (TGA) is a congenital heart defect caused due to the abnormal development of the fetal heart during the first 8 weeks of pregnancy. It is usually associated with left ventricle outflow tract (LVOT) obstruction. Due to the provision of low amounts of oxygen to the body, this heart problem is also called the "blue-baby syndrome." TGA is the second most common congenital heart defects prevalent in early infancy and occurs in roughly 3% of all heart-related birth defects. Common symptoms include clammy and blue (cyanosis) skin, poor weight gain, lack of appetite and laboured breathing. While some factors like viral illnesses during pregnancy, maternal age over 40 or maternal diabetes may increase the risk of this condition, in most cases the cause is unknown.
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