NEW DELHI || Doctors at Fortis Hospital, Shalimar Bagh performed life-saving cardiac surgery on a 24 hours old baby boy here recently. The baby was born with a narrow aortic valve with a missing leaflet that restricted free blood flow to the body. A team of experts led by Gaurav Garg, Senior Consultant, Paediatric Cardiology, Fortis Hospital Shalimar Bagh.
The case came to the hospital when the family came for a fetal assessment on 34th week of pregnancy; i.e. at eight and a half months pregnant. On evaluation, it was diagnosed that the baby’s heart had a major cardiac defect with a narrow aortic valve with two leaflets instead of three.
The doctors counselled the family about the consequences and drew up a plan to treat after birth. The delivery was regular without any complications. However, the baby condition started to deteriorate soon after and immediate surgical intervention was done as per the plan.
Garg said, “The biggest challenge was ensuring that the baby was born without any further complications. After birth, we kept him under strict supervision in the NICU (neo-natal ICU). Within 24 hours the baby’s condition deteriorated rapidly, and we put him on a ventilator. He was taken to the Cath lab where the narrowed valve was successfully opened. The entire surgical intervention lasted 2 hours. The main challenge was that the cardiac structures of a newborn baby are very soft and small, requiring precision in execution, right from taking vascular access to entering the heart. Thankfully everything went well.”
Thanking the hospital for the treatment, mother of the baby said, “We are really happy that our baby was saved by the doctors. After a day of the surgery, he was taken off the ventilator and I began feeding. It was the most overwhelming feeling. My baby is normal and healthy now with no signs of any disturbance. The correct antenatal diagnosis, counselling, and planning helped a lot to save the baby.”
Mahipal Singh Bhanot, Facility Director, Fortis Hospital Shalimar Bagh said, “Our endeavour is to always ensure a patient-centric approach and provide the best clinical care possible. In this case, teamwork and careful deliberation allowed our experts to arrive at the correct diagnosis and subsequent treatment approach. We worked very closely with the mother who was apprehensive as it was her first pregnancy and was proving to be a difficult one. We are very happy at the successful outcome of this case and our team will continue to work diligently as per global clinical protocols and leverage cutting edge technology for the best possible results.”
When the aortic valve has only two (instead of three) leaflets, it is called a bicuspid aortic valve (or BAV). Often the valve leaflets are thickened and less pliable than normal, and the lines of separation between them are fused together to a variable degree. A newborn with critical aortic valve stenosis develops heart failure in the first days of life. This is an emergency that requires immediate treatment, either balloon dilation of the valve or surgery.