A courageous ‘go-ahead’ by a young woman for doctors to perform an extremely risky procedure on her baby to rectify serious heart defects has revolutionised the medical field in India – because the procedure was carried out successfully when the baby was still in her womb.

The baby – a foetus of 27 weeks – was diagnosed in the pre-natal stage with a 99 per cent block of the aortic valve which allows purified blood into the largest artery in the heart, called aorta.

Because of the block, a resulting leak in the mitral valve (which allows one-way flow of impure blood into the left ventricle) allowed the pure blood to mix with the impure blood in the left atrium of the heart. That led to shrinking of the left side of the heart.

If the defect was not corrected, the baby may not have survived in the womb, or would have been born with the defect to lead an uncertain, short life full of complications.

A team of eight cardiac specialists led by Dr. K Nageswara Rao, chief paediatric cardiologist at Care Hospital, Banjara Hills in Hyderabad – where the rare surgery took place on October 23 – successfully completed the surgery that took 150 minutes. The specialists were aided by 22 assistants, considering the complexity of procedures which involved cardiology, obstetrics, and gynaecology and paediatric fields of medicine.

And the highly complicated procedure became possible to be completed successfully because the mother, M Sirisha, a science teacher, easily understood the science and the problem, according to the doctors.

She gave her nod. When the first attempt failed in the 25th week, the parents were upset. But, we convinced them that the position of the foetus in the womb was the hurdle to the procedure.

In the 27th week, the team got experts to change the position of the baby inside the womb so as to allow the cardiac specialists to conduct the procedure.

They used a special-sized balloon with a special 18 gauge needle (imported from the US) to its baby’s thigh. The needle was inserted through the wall of the mother (Sirisha’s) womb, the doctors explained.

Dr Nageswara Rao said the procedure was successfully completed, but still only 60 per cent of the work has been done, with the rest 40 per cent to be completed after the baby is born in December third week.

Dr Rao is excited. “I have been waiting for ten long years to perform this surgery. Though we tried one three years ago (a different case), the surgery failed and the baby died. Now, this baby will be born healthy and will be normal once the remaining part of the correction is carried out,” he said. Such surgeries are performed in the UK and the USA but this is the first time such an operation has been conducted in India.

Noted cardiologist and chairman of Care Hospital, Dr. Soma Raju, said, “Hitherto, parents preferred termination of pregnancy in almost all such cases. In cases which were not diagnosed, the babies are born dead or die soon after birth. Now, we can say we have overcome one more health challenge.

Sirisha, already a young mother of 25 with a 20-month-old son, said, “The problem was diagnosed during a regular pre-natal test at some other centre. They directed me to Dr. Nageswara Rao who gave me the confidence that the procedure can be carried out successfully. We are now very happy, waiting for the delivery.”

The significance of the success of the surgery is in the fact that parents who seek similar procedures abroad would be able to get it done in India at much lower costs. However, Care Hospital has kept the cost aspect confidential even while indicating that the procedure would cost anywhere above Rs 3 lakh.

source: http://www.bangaloremirror.com / Bangalore Mirror / Home> Bangalore> Others / by P Pavan, Bangalore Mirror Bureau / October 31st, 2014