A neonate of age only 15 days, weighing 470 grams and of almost the size of a palm was suffering from a very challenging and complex heart condition. The baby, born after a gestation period of 28 weeks, survived all odds to be the first case of its kind in medical history of the world. The baby is the lightest and youngest Indian to have undergone a successful heart surgery in Neonatal Intensive Care Unit (NICU).
S.P. Jain and his wife, both residents of Udaipur, conceived after many years of marriage through IVF procedure from a nearby hospital. The baby was delivered by Lower Segment Caesarean Section (LSCS) procedure, in the 28th week of pregnancy.
The baby developed breathing difficulties immediate after his birth. The baby was placed under the expert care of Neonatologist, Dr. Sunil Jangid of Jeevanta Hospital, in the state-of-the-art Neonatal Intensive Care Unit (NICU). Initial investigation of Echo-Cardiography by cardiologist Dr. Ramesh Patel of Geetanjali Hospital confirmed that the baby suffered from a condition in which the two major blood vessels of heart- aorta and pulmonary artery were connected. The connection between the two arteries is present till the fetus is inside a mother’s womb. It automatically stops after the birth. If it doesn’t happen then is being treated with the help of medicines. But in this case, heart surgery was the last option available since the baby didn’t responded with medicines.
With the permission from parents’ , Jeevanta Hospital’s team decided to call Geetanjali Medical College & Hospital’s Cardio Vascular & Thoracic Surgeon Dr. Sanjay Gandhi who had already performed such operation of a neonate weighing 700 grams at GMCH and Jaipur’s Cocoon Hospital.
Timely intervention and immediate assistance was required so Executive Director Ankit Agarwal, permitted their cardiac team to perform the operation in Jeevanta Hospital to save infant. Dr. Gandhi took only 30 minutes for the completion of successful surgery. With the help of cautery machine and surgical instruments, the connection was stopped using a clip and surgical sutures. The surgery also assured no internal bleeding.
It was the baby’s low weight that prompted doctors to operate in NICU only as the shifting from one hospital to another or from NICU to an operation theatre could have been life threatening. “The journey from NICU to the operation theatre could be fatal for such micro-preemies given tender weakness and low weight,” said Dr. Gandhi. Hence the team of surgeons and anesthetists, including Dr. Sanjay Gandhi, Dr. Ankur Gandhi, Dr. Kalpesh Mistry, Dr. Manmohan Jindal & Dr. Dharamchand gathered in NICU to treat this condition. “It’s really a very difficult procedure because very small & specific instruments are needed to operate on such small children and to resuscitate them from a complex heart disease”, said Dr Gandhi.
“Nowadays, most PDAs closures are done with medicines, but only in rare cases heart surgery is required. It’s really encouraging that children so young and of weight less than 500 grams can be operated,” said Dr. Gandhi & Dr. Jangid. Dr. Sanjay Gandhi also claimed, “It’s difficult to say off-hand, but he is the smallest baby to have undergone this heart surgery with the lowest weight in India as well as world.”
For the parents, it’s not more than a miracle for their child to have survived against all the odds. “Thanks to God and doctors, my son survived though he had such low birth weight and was a pre-term neonate”, said the parents.
Born at 28 weeks of pregnancy and weighing 470 grams, is possible the lightest baby to survive in the world. He had weak muscles, rib cage and immature lungs. Brain, kidney, liver, heart etc. were weak. He was also diagnosed with no immunity, more chances of infections and internal bleeding (due to noise/injecting doses with force) which may cause sudden death. He was supplied the essential nutrients and glucose through central line drip. The medicines given as surfactant may result in delay in growth, lungs diseases, brain development problems, hole in intestines, enlargement of liver etc.
He became the lightest in the world to undergo a PDA corrective operation. The previous cases so registered claims to operate on neonates weighing 550 grams, 580 grams & many in India. Out of every one thousand babies only 3 or 4 have a complex heart disease like this. The baby is recovering well.