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Infant undergoes beating heart surgery

This is the first time in India that a beating heart Coronary Artery Bypass Graft (CABG) has been performed on an infant so young and in so critical a condition.

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A few months ago, when Arjun Shah (name changed) suffered a massive heart attack at the tender age of one, doctors in the United States, where the Shahs work as computer engineers, told the family that there was very little they could do to save him.

However, five days ago, a team of paediatric cardiologists performed a surgery which has not only given the 15-month-old a new lease of life, but has also caused a lot of excitement in the medical fraternity.

Paediatric cardiologists at the Wockhardt Hospital’s Paediatric and Congenital Heart Centre at Mulund, where the surgery was performed, say this is the first time in India that a beating heart Coronary Artery Bypass Graft (CABG) has been performed on an infant so young and in so critical a condition.

“What makes the procedure so unique is the fact that it was a beating heart surgery, which means that unlike during bypass surgery, where the heart is stopped and attached to an artificial heart-lung machine, little Arjun’s heart was kept beating during the entire three-hour-long procedure,” explained Dr Suresh Joshi, the paediatric cardiac surgeon who headed the team that performed the crucial surgery.

Arjun’s condition — severe narrowing of the left coronary artery — was first noticed by doctors during an Echocardiogram, when he was just two-months-old.

According to experts, the heart vessel defect is so rare, that it affects just one in every one lakh children. “Of every 10,000 newborns with a defect in the heart, just one might have this defect,” said Dr Swati Garekar, consultant pediatric cardiologist.

The condition of Arjun’s heart worsened over a period of a few months, resulting in a chronic myocardial infraction (heart attack). “At the time of the surgery, the coronary artery measured just 1-1.2mm. There was 100 per cent blockage, and the pumping power of the heart was as low as 20 per cent — about 1/3rd of normal,” said Dr Joshi.

Arjun had symptoms of heart failure — difficulty in breathing, frequent vomiting, inactiveness - and weighed just seven kgs. “Medications were not helping. So we had just two options — to perform a surgery, which was very high risk, or to wait for a heart transplant,” said Dr Garekar.

Once cardiologists decided upon surgery, they were faced with another problem. “Arjun’s heart function was so poor that once stopped it would not have revived. Bypass surgery would have been fatal. The only option left was to perform a beating heart surgery, which had never been performed in India before,” said Dr Joshi.

Arjun is being closely monitored round-the-clock by a team of doctors and nursing staff and will be discharged in another week’s time, said doctors.

Arjun’s parents, Navi Mumbai residents who now work as computer engineers with Tata Consultancy Services, are yet to come to terms with the fact that their young son has had a miraculous escape.

“We will be in a position to talk about this only when our son is out of the hospital and completely normal,” said the father of the child, requesting anonymity.

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