~Amidst Covid-19, the baby with severely obstructed aortic valve, 15% heart pump rate successfully underwent balloon aortic valvotomy, delay in treatment can lead to the loss of life~
~This condition is seen in 2% of the overall population, among this 15-20 % will have blocked valve, 25% will present with this condition after 1 month of birth~
by Priya Jadhav
Mumbai, July 2020: A team of doctors at Jerbai Wadia Hospital for Children performed a high-risk balloon aortic valvotomy procedure on a newborn baby boy from Ahmednagar with blocked valve, 15% heart pumping rate, breathing problem, and murmuring of heart. The baby boy showed immediate significant improvement in the heart pumping capacity after the opening of the valve. He is off the ventilator now and recovering well.
Parenthood is a blessing! Ahmednagar’s 26-year-old young couple Namita (name changed) and Naresh Sahu (name changed) were prepping up to embrace parenthood for the first time. Though, the Covid-19 pandemic has set in paranoia. The couple kept their cool and eagerly waited to welcome their newborn. They ensured that they followed the Covid-19 protocol that is wearing mask, physical distancing, and limiting outdoor visits. The couple’s joy knew no bounds when Namita gave birth to a baby boy weighing 2.5 kgs .
8 days later, the mother realized that the baby’s breathing was rapid and worsened after breastfeeding. The disheartened parents took the baby to a local paediatrician who also detected a heart murmur (It is an abnormal sound as blood moves through the heart. It means there is a heart defect). The echocardiography test carried out in Loni, Ahmednagar revealed that his aortic valve (major heart valve) was blocked by birth and the heart pump rate was 15% (55 percent or higher is considered normal). However, the baby was referred to Wadia Hospital, and was brought by ambulance from Ahmednagar to Mumbai.
The treating doctor said,"The baby came in an emergency and his health worsened. The cardiac team including the Paediatric Cardiac Anesthetist, Interventional Cardiologist, nursing, and the technical team took precautions by wearing 4 layers of covering (including lead aprons and PPE kit) in view of baby’s unknown Covid status. Bedside echocardiography was performed which confirmed severely obstructed aortic valve and heart pump failure. The baby was immediately admitted to the Isolation unit and put on a ventilator in view of severe breathing difficulty.”
This congenital condition is seen in 2% of the overall population, among this, 15-20 % will have blocked valve, 25% will present with this condition after 1 month of birth. Medicines were started to help improve the heart pumping and the blood circulation to the vital organs. The baby and mother’s nasal swab was sent for the Covid-19 test. In view of the overall sick condition of the baby, it was decided to perform emergency surgery for opening the heart valve. Delaying the surgery could have cost him his life. Hence, he was shifted to the cardiac catheterization laboratory for the procedure after initial stabilization.
Doctor said, “The baby underwent Balloon aortic valvotomy or balloon aortic valvuloplasty is a minimally-invasive surgery is done with cardiac catheterization using a catheter with a deflated balloon in the tip. The catheter is inserted into a blood vessel. It is moved to the narrowed valve, and the balloon is inflated to open the heart valve. The challenging procedure lasted for 2 hours, and his echocardiography showed immediate significant improvement in the heart pumping capacity after the opening of the valve. The baby was shifted back to the Isolation unit for further management.”
The baby’s Covid test was negative. However, the mother tested positive and had to be shifted to Kasturba Hospital for isolation. The baby was then shifted to the cardiac ICU and is off ventilator now, and will be discharged soon.
Baby’s joyous father Naresh Sahu, said, “We were fretting due to the outbreak of Covid-19. But, we ensured that we take all the necessary precautions. We were elated after the birth of our first baby. Our world came crashing down when he was diagnosed with a heart defect. We would have lost our baby if he wouldn’t have received timely and prompt treatment at Wadia Hospital. We appreciate the safety measures and efforts taken by the doctors to save our baby. I am excited to go back home with them.”
“At Wadia hospital, we continue to cater to challenges and successfully manage such children apart from managing children with Covid infection. These kinds of cases reveal the capabilities of our team of doctors, nurses and technicians and for the excellence in providing healthcare which we have been always known for,” concluded Dr Minnie Bodhanwala, CEO, Wadia Group of Hospitals.